Cure for alcoholism
Alcoholism is a chronic or periodic consumption of alcohol characterized by impaired control over drinking, intoxication episodes, and preoccupation with alcohol.
Alcohol abuse leads to psychological, mental and physical impairment and therefore should be treated. Treatment of alcoholism includes both pharmacological and nonpharmacological measures, although nonpharmacological treatment is preferable.
Pharmacotherapy hasn’t shown any benefit in alcoholism treatment except the management of the withdrawal syndrome.
- Benzodiazepines: Diazepam, Chlordiazepoxide are prescribed with a dose of 20 mg four times a day for 7 days to cope with alcohol withdrawal. The impairment of liver functioning is a common side effect of the benzodiazepines.
- Antipsychotics may be used only in case of severe withdrawal when hallucinations and severe agitation occur, although their use during withdrawal is problematic due to its side effects such as the lower seizures threshold and, therefore, the easy development of seizures.
- Alcohol sensitizing drugs: The medications that cause the unpleasant feeling after the consumption of alcohol are called alcohol-sensitizing drugs. They were invented in the 1940th and since then Disulfiram (Antabuse) has been prescribed for the treatment of alcoholism. The common dose of the drug varies from 125 mg to 500 mg given orally. In some cases to reach a desirable effect higher dosages are required (1 g/day).
The drug interferes with the enzymes that are involved in the alcohol metabolism, especially ALDH (Aldehyde dehydrogenase), and therefore causes an unpleasant feeling after the consumption of alcohol. Alcohol consumption after the administration of this medication causes elevated production of acetaldehyde. This substance is responsible for the development of the so-called disulfiram-ethanol reaction (DER).
1.1. Side effects of disulfiram include:
- Sometimes psychosis;
- Exacerbation in those who suffer from schizophrenia;
- A person should be aware that disulfiram may interact with over-the-counter drugs and alcohol used in food preparations.
- Alcohol-related neurologic disturbances may be avoided by the administration of thiamine and multivitamineswith a dose of 50-100 mg/day orally or intramuscularly.
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 that may be used to motivate or direct persons and their families through the course of recovery.
- Cognitive and behavior therapies are usually used. 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.
- The twelve steps therapy by Alcoholic Anonymous has also been reported as an effective one. The A.A. groups gradually growth and have shown benefits as an additional treatment measure.
- Social detoxification is an effective nonpharmacological measure used to treat alcohol withdrawal and includes:
- frequent reassurance;
- reality orientation;
- monitoring of vital signs;
- personal attention and general nursing care.
Detoxification is possible on ambulatory basis.
Treatment of comorbidities
Comorbid disorders such as anxiety, depression, anger and many other emotional conditions are contributing to the relapse and should be treated.
SSRIs are used to treat depressive symptoms. Anxiolytics (benzodiazepine and nonbenzodiazepines) are also prescribed.