Treatments for Alcoholism
Treatments for Alcoholism
The list of treatments mentioned in various sources
for Alcoholism
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Admission of having a problem
- Detoxification (drying out)
- Counselling
- Support groups
- Alcoholics Anonymous
- Avoidance of alcohol
- Aversion therapy
- Avoiding friends who abuse alcohol
- Other treatments for any complications
- Vitamin B2 - possibly used if for treatment of vitamin B2 deficiency
- Vitamin B1 - possibly used for related Vitamin B1 deficiency
- Vitamin B6 - possibly used for treatment of vitamin B6 deficiency
- Vitamin B5 - possibly used for treatment of related vitamin B5 deficiency
- Self-help programs, Support group, Counselling, Nutrition, Exercise, Medications - antabuse, naltrexone, acamprosate, topiramate
Alcoholism: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Alcoholism may include:
Hidden causes of Alcoholism may be incorrectly diagnosed:
Alcoholism: Research Doctors & Specialists
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- Liver Health Specialists (Hepatology):
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Drugs and Medications used to treat Alcoholism:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Alcoholism include:
Latest treatments for Alcoholism:
The following are some of the latest treatments for Alcoholism:
- Aldehyde dehydrogenase inhibitors
- Acamprosate
- Cognitive behaviour therapy
- Social skills training
- Curcumin
Hospital statistics for Alcoholism:
These medical statistics relate to hospitals, hospitalization and Alcoholism:
- 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)
- 69% of hospital consultant episodes for mental and behavioural disorders due to alcohol use were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 31% of hospital consultant episodes for mental and behavioural disorders due to alcohol use were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 79% of hospital consultant episodes for mental and behavioural disorders due to alcohol use required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: Alcoholism
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to Alcoholism:
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More general information, not necessarily in relation to Alcoholism,
on hospital and medical facility performance and surgical care quality:
Medical news summaries about treatments for Alcoholism:
The following medical news items
are relevant to treatment of Alcoholism:
Discussion of treatments for Alcoholism:
Alcoholism Getting the Facts: NIAAA (Excerpt)
People who are not
alcoholic sometimes do not understand why an alcoholic can’t just
“use a little willpower” to stop drinking. However, alcoholism has
little to do with willpower. Alcoholics are in the grip of a
powerful “craving,” or uncontrollable need, for alcohol that
overrides their ability to stop drinking. This need can be as strong
as the need for f ood or
water.
Although
some people are able to recover from alcoholism without help, the
majority of alcoholics need assistance. With treatment and support,
many individuals are able to stop drinking and rebuild their
lives. (Source: excerpt from Alcoholism Getting the Facts: NIAAA)
Alcoholism Getting the Facts: NIAAA (Excerpt)
The type
of treatment you receive depends on the severity of your alcoholism
and the resources that are available in your community. Treatment
may include detoxification (the process of safely getting alcohol
out of your system); taking doctor-prescribed medications, such as
disulfiram (Antabuse®) or naltrexone (ReVia™),
to help prevent a return (or relapse) to drinking once drinking has
stopped; and individual and/or group counseling. There are promising
types of counseling that teach alcoholics to identify situations and
feelings that trigger the urge to drink and to find new ways to cope
that do not include alcohol use. These treatments are often provided
on an outpatient basis. (Source: excerpt from Alcoholism Getting the Facts: NIAAA)
Alcoholism Getting the Facts: NIAAA (Excerpt)
Virtually
all alcoholism treatment programs also include Alcoholics Anonymous
(AA) meetings. AA describes itself as a “worldwide fellowship of men
and women who help each other to stay sober.” Although AA is
generally recognized as an effective mutual help program for
recovering alcoholics, not everyone responds to AA’s style or
message, and other recovery approaches are available. Even people
who are helped by AA usually find that AA works best in combination
with other forms of treatment, including counseling and medical
care. (Source: excerpt from Alcoholism Getting the Facts: NIAAA)
Alcoholism Getting the Facts: NIAAA (Excerpt)
If your
health care provider determines that you are not alcohol dependent
but are nonetheless involved in a pattern of alcohol abuse, he or
she can help you to:
• Examine
the benefits of stopping an unhealthy drinking pattern.
• Set a drinking
goal for yourself. Some people choose to abstain from alcohol.
Others prefer to limit the amount they drink.
• Examine the
situations that trigger your unhealthy drinking patterns, and
develop new ways of handling those situations so that you can
maintain your drinking goal.
Some
individuals who have stopped drinking after experiencing
alcohol-related problems choose to attend AA meetings for
information and support, even though they have not been diagnosed as
alcoholic. (Source: excerpt from Alcoholism Getting the Facts: NIAAA)
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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
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
Drug abuse and dependence:
Treatment
(Handbook of Diseases)
The patient may first need treatment for drug intoxication, followed by long-term therapy to combat drug dependence.
Drug intoxication
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, and detoxification with the same drug or a pharmacologically similar drug. (Exceptions include cocaine, hallucinogens, and marijuana, which aren’t used for detoxification.)
Medications include sedatives to induce sleep; anticholinergics and anti-diarrheals to relieve GI distress; anti-anxiety drugs for severe agitation, especially in cocaine abusers; and symptomatic treatment of complications.
Depending on the dosage and time elapsed before admission, additional treatments may include gastric lavage, induced vomiting, activated charcoal, forced diuresis and, possibly, hemoperfusion or hemodialysis.
Drug dependence
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 or a similar self-help group.
Detoxification, the controlled and gradual withdrawal of an abused drug, is achieved through substitution of a drug with similar action, which is then gradually decreased. 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 CNS 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 requires hospitalization. Withdrawal from CNS depressants usually doesn’t require detoxification.
Opioid withdrawal causes severe physical discomfort and can even 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 of drug abuse. Rehabilitation programs are available for both 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 beneficial. The largest such group is Narcotics Anonymous.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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
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