Treatments for Alcohol abuse
Treatments for Alcohol abuse
The list of treatments mentioned in various sources
for Alcohol abuse
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Alcohol abuse: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Alcohol abuse may include:
Alcohol abuse: Research Doctors & Specialists
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Unlabeled Drugs and Medications to treat Alcohol abuse:
Unlabelled alternative drug treatments for Alcohol abuse include:
Latest treatments for Alcohol abuse:
The following are some of the latest treatments for Alcohol abuse:
Hospital statistics for Alcohol abuse:
These medical statistics relate to hospitals, hospitalization and Alcohol abuse:
- alcohol related mental and behavioural disorders resulted in 13,864 hospitalisations in Australia 2001-02 (AIHW Hospital Morbidity Database 2001-02, Australia’s Health 2004, AIHW)
- alcohol related mental and behavioural disorders accounted for 82,708 patient days in hospitals in Australia 2001-02 (AIHW Hospital Morbidity Database 2001-02, Australia’s Health 2004, AIHW)
- 0.26% (33,701) of hospital consultant episodes were for mental and behavioural disorders due to alcohol use in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 86% of hospital consultant episodes for mental and behavioural disorders due to alcohol use required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: Alcohol abuse
Research quality ratings and patient incidents/safety measures
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More general information, not necessarily in relation to Alcohol abuse,
on hospital and medical facility performance and surgical care quality:
Medical news summaries about treatments for Alcohol abuse:
The following medical news items
are relevant to treatment of Alcohol abuse:
Discussion of treatments for Alcohol abuse:
Alcohol Abuse and Treatment: NWHIC (Excerpt)
Alcoholism is a disease and has no cure, but can be managed with
medical treatment and social support groups. This means that even if an
alcoholic has been sober for a long time and has regained health, he or
she may relapse, and must continue to avoid all alcoholic beverages. The
most common and most effective way to combat alcohol abuse is through a
systematic support group, with advice and support from a health care
professional. (Source: excerpt from Alcohol Abuse and Treatment: NWHIC)
Aging and Alcohol Abuse: NIAAA (Excerpt)
You can begin getting help by calling your family doctor or clergy member.
Your local health department or social services agencies also can help.
(Source: excerpt from Aging and Alcohol Abuse: NIAAA)
How to Cut Down on Your Drinking: NIAAA (Excerpt)
Your doctor
will be able to tell you whether you should cut down or abstain. If you
are alcoholic or have other medical problems, you should not just cut down
on your drinking--you should stop drinking completely. Your doctor will
advise you about what is right for you.
(Source: excerpt from How to Cut Down on Your Drinking: NIAAA)
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Book Excerpts: Treatment of Alcohol abuse
Treatments of Alcohol abuse: Online Medical Books
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for more information about the treatments of Alcohol abuse.
Alcohol-related disorder:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Total abstinence from alcohol is the only effective treatment. Supportive programs that offer detoxification, rehabilitation, and aftercare, including continued involvement in Alcoholics Anonymous (AA), may produce good long-term results.
Acute intoxication is treated symptomatically by supporting respiration, preventing aspiration of vomitus, replacing fluids, administering I.V. glucose to prevent hypoglycemia, correcting hypothermia or acidosis, and initiating emergency treatment for trauma, infection, or GI bleeding.
Treatment of chronic alcohol abuse requires a varied approach that may include medications to deter alcohol use and treat effects of withdrawal; psychotherapy, consisting of behavior modification techniques, group therapy, and family therapy; and appropriate measures to relieve associated physical problems.
Aversion, or deterrent, therapy involves a daily oral dose of disulfiram to prevent compulsive drinking. This drug interferes with alcohol metabolism and allows toxic levels of acetaldehyde to accumulate in the patient’s blood, producing immediate and potentially fatal distress in the event he consumes alcohol up to 2 weeks after taking it. Disulfiram is contraindicated during pregnancy and in the patient with diabetes, heart disease, severe hepatic disease, or any disorder in which such a reaction could be especially dangerous. Another form of aversion therapy attempts to induce aversion by administering alcohol with an emetic.
The first drug approved by the U.S. Food and Drug Administration for the treatment of alcohol-related disorder since disulfiram is naltrexone, an opiate antagonist that effectively reduces the amount of intake, severity of craving, and relapse incidence. It’s believed to work by preventing the effects of increased endorphins produced as a product of increased alcohol intake.
For long-term success, the recovering individual must learn to fill the place alcohol once occupied in his life with something constructive. Therapy using disulfiram or naltrexone may only substitute one drug dependence for another, so it should be used prudently.
Benzodiazepine isn’t recommended during rehabilitation due to its addictive nature and the potential for reinforcing the substance abuse behavior.
ELDER TIP Because the older patient may be more sensitive to these drugs, withdrawal may take longer (weeks or months) and be more severe than in a younger adult.
Supportive counseling or individual, group, or family psychotherapy may help. Ongoing support groups are helpful. In AA, a self-help group with more than 1 million members worldwide, the alcoholic finds emotional support from others with similar problems. About 40% of AA’s members stay sober as long as 5 years, and 30% stay sober longer than 5 years.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Substance abuse and induced disorders:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The patient with acute drug intoxication should receive symptomatic treatment based on the drug ingested. Measures include fluid replacement therapy and nutritional and vitamin supplements, if indicated; detoxification with the same drug or a pharmacologically similar drug (exceptions include cocaine, hallucinogens, and marijuana, which aren’t used for detoxification); sedatives to induce sleep; anticholinergics and antidiarrheal agents to relieve GI distress; antianxiety drugs for severe agitation, especially in cocaine abusers; and symptomatic treatment of complications. Depending on the dosage and time elapsed before admission, additional treatment may include gastric lavage, induced emesis, activated charcoal, forced diuresis and, possibly, hemoperfusion or hemodialysis.
Treatment of drug dependence commonly involves a triad of care: detoxification, short- and long-term rehabilitation, and aftercare; the latter means a lifetime of abstinence, usually aided by participation in Narcotics Anonymous (NA) or a similar self-help group.
Detoxification, the controlled and gradual withdrawal of an abused drug, is achieved through substituting a drug with a similar action. Such gradual replacement of the abused drug controls the effects of withdrawal, thereby reducing the patient’s discomfort and associated risks.
Depending on which drug the patient has abused, detoxification may be managed on an inpatient or outpatient basis. For example, withdrawal from depressants can produce hazardous adverse reactions, such as generalized tonic-clonic seizures, status epilepticus, and hypotension. The severity of these reactions determines whether the patient can be safely treated as an outpatient or if he requires hospitalization. Withdrawal from depressants usually requires detoxification because abrupt or poorly managed withdrawal from barbiturates can cause death.
Opioid withdrawal causes severe physical discomfort and can be life threatening. To minimize these effects, chronic opioid abusers commonly are detoxified with methadone.
To ease withdrawal from opioids, depressants, and other drugs, useful nonchemical measures may include psychotherapy, exercise, relaxation techniques, and nutritional support. Sedatives and tranquilizers may be administered temporarily to help the patient cope with insomnia, anxiety, and depression.
After withdrawal, the patient needs to participate in a rehabilitation program to prevent a recurrence. Rehabilitation programs are available for inpatients and outpatients; they usually last a month or longer and may include individual, group, and family psychotherapy. During and after rehabilitation, participation in a drug-oriented self-help group may be helpful. The largest such group is NA.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cirrhosis and fibrosis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment is designed to remove or alleviate the underlying cause of cirrhosis or fibrosis, prevent further liver damage, and prevent or treat complications. The patient may benefit from a high-calorie and moderate- to high-protein diet, but developing hepatic encephalopathy mandates restricted protein intake. In addition, sodium is usually restricted to 200 to 500 mg/day and fluids to 1 to 1½ qt (1 to 1.5 L)/day.
If the patient’s condition continues to deteriorate, he may need tube feedings or total parenteral nutrition. He may also need supplemental vitamins — A, B complex, D, and K — to compensate for the liver’s inability to store them and vitamin B12, folic acid, and thiamine for deficiency anemia. Rest, moderate exercise, and avoidance of exposure to infections and toxic agents are essential.
Drug therapy requires special caution because the cirrhotic liver can’t detoxify harmful substances efficiently. When absolutely necessary, vasopressin may be prescribed for esophageal varices, and diuretics may be given for edema. However, diuretics require careful monitoring because fluid and electrolyte imbalance may precipitate hepatic encephalopathy. Encephalopathy is treated with lactulose. Antibiotics are used to decrease intestinal bacteria and reduce ammonia production, which causes encephalopathy. Coagulopathy may be treated with blood products or vitamin K.
Low-protein diets are controversial. They aid in managing acute hepatic encephalopathy but are rarely necessary in chronic conditions because of the underlying protein-calorie malnutrition.
Paracentesis and infusions of salt-poor albumin, in addition to fluid and salt restriction, may alleviate ascites. Surgical procedures include treatment of varices by upper endoscopy with banding or sclerosis, splenectomy, esophagogastric resection, and splenorenal or portacaval anastomosis to relieve portal hypertension. (See Portal hypertension and esophageal varices, page 758, and Circulation in portal hypertension, page 759.)
Alert If cirrhosis progresses and becomes life-threatening, a liver transplant should be considered.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Weight gain, excessive:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Educating the patient about weight control is extremely important. Stress the benefits of behavior modification and dietary compliance. Help the patient plan an appropriate exercise routine.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Alcoholism:
Treatment
(Handbook of Diseases)
Total abstinence from alcohol is the only effective treatment. Supportive programs that offer detoxification, rehabilitation, and aftercare, including continued involvement in Alcoholics Anonymous, may produce good long-term results.
Acute intoxication is treated symptomatically by supporting respiration, preventing aspiration of vomitus, replacing fluids, administering I.V. glucose to prevent hypoglycemia, correcting hypothermia or acidosis, and initiating emergency treatment for trauma, infection, or GI bleeding. Acute withdrawal is also treated with oral multiple B vitamins, including thiamine. Administer fluids as needed, but avoid overhydrating the patient.
CLINICAL TIP: The possibility of intoxication with other drugs should be considered and a blood or urine sample sent for toxicology as appropriate.
Treatment of chronic alcoholism involves counseling, education, and cognitive techniques; psychotherapy (consisting of behavior modification techniques, group therapy, and family therapy); and appropriate measures to relieve associated physical problems.
Aversion, or deterrent, therapy may involve a daily oral dose of disulfiram to prevent compulsive drinking. (See Avoiding the risks of disulfiram therapy.)
UNDER STUDY: The opioid-antagonist drug naltrexone has been shown to reduce the ability to return to drinking and shorten periods of relapse. Longer-term trials are needed.
Tranquilizers, particularly the benzodiazepines, are used to decrease withdrawal symptoms of the central nervous system and are administered routinely to decrease risk of seizures. These drugs are administered and decreased over 3 to 5 days. Status epilepticus should be treated aggressively; initial treatment with lorazepam I.V. is effective.
Supportive counseling or individual, group, or family psychotherapy may help. Ongoing support groups are also helpful.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Cirrhosis:
Treatment
(Handbook of Diseases)
The goals of treatment include removing or alleviating the underlying cause of cirrhosis or fibrosis, preventing further liver damage, and preventing or treating complications.
Dietary measures
The patient may benefit from a high-calorie and moderate- to high-protein diet, but if the patient develops hepatic encephalopathy, protein intake must be restricted. In addition, sodium is usually restricted to 400 to 800 mg/day; fluids, to 1,000 to 1,500 ml/day.
If the patient’s condition continues to deteriorate, he may need tube feedings or hyperalimentation. Other supportive measures include supplemental vitamins — A, B complex, D, and K — to compensate for the liver’s inability to store them and vitamin B, folic acid, and thiamine for deficiency anemia. Rest, moderate exercise, and avoidance of exposure to infections and toxic agents are essential.
Drug therapy
With cirrhosis, drug therapy requires special caution because the cirrhotic liver can’t detoxify harmful substances efficiently. Alcohol is prohibited; sedatives should be avoided or prescribed with great care. Acetaminophen is especially hepatotoxic, particularly when combined with alcohol.
When absolutely necessary, an antiemetic, such as trimethobenzamide or benzquinamide, may be given for nausea; vasopressin, for esophageal varices; and a diuretic, such as furosemide or spironolactone, for edema. However, if the patient receives a diuretic, careful monitoring is necessary; fluid and electrolyte imbalance may precipitate hepatic encephalopathy.
Vitamin K may be given for bleeding tendencies due to hypoprothrombinemia. Transfusion of blood and fresh frozen plasma may also be necessary.
A beta-adrenergic blocker may be given to decrease pressure from varices.
Lactulose may be given orally or rectally to reduce a high ammonia level. If lactulose therapy alone is inadequate, neomycin may be used.
Other treatment
Paracentesis and infusions of salt-poor albumin may alleviate ascites. Surgical procedures include ligation of varices, splenectomy, esophagogastric resection, and splenorenal or portacaval anastomosis to relieve portal hypertension.
Clinical tip Transjugular intrahepatic portosystemic shunt is an alternative to surgical shunting in patients with variceal bleeding refractory to standard therapy. It’s also helpful in patients with severe ascites. The technique involves insertion of an expandable metal shunt between a branch of the hepatic vein and portal vein over a catheter inserted via the jugular vein. This is usually a bridging mechanism to control variceal bleeding or ascites until liver transplantation can be performed.
Hepatorenal and hepatopulmonary syndromes may occur. Treatment is ineffective except in patients who are acceptable candidates for liver transplantation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Weight gain, excessive:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Educating the patient about weight control is extremely important. Stress the benefits of behavior modification and dietary compliance. Help the patient plan an appropriate exercise routine.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Weight loss, excessive:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Refer your patient for psychological counseling if weight loss negatively affects his body image. Teach the patient about his diet and recommend that he keep a food diary. Determine his food preferences and try to incorporate them into his diet. Encourage oral hygiene before meals to make the food more palatable.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Weight gain, excessive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Refer the patient for psychological counseling, as necessary.
▪ If the patient is obese or has a cardiopulmonary disorder, monitor exercise closely.
▪ Perform studies to rule out possible secondary causes should include serum thyroid-stimulating hormone determination and dexamethasone suppression testing.
▪ Perform laboratory tests for thyroid function and serum cholesterol, triglyceride, and glucose levels.
Patient teaching
▪ Explain to the patient the cause of weight gain, if known.
▪ Teach the patient about appropriate dietary choices and discuss an individualized exercise plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Weight loss, excessive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Take daily calorie counts and weigh the patient weekly.
▪ Consult a nutritionist to determine an appropriate diet and nutritional supplements with adequate calories.
▪ Administer hyperalimentation or tube feedings to maintain nutrition, as needed.
Patient teaching
▪ Provide instruction in proper nutrition and keeping a food diary.
▪ Instruct the patient in proper oral hygiene.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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