Question

identify several drugs and non drug measures that have some hope of stopping or reducing the problems of chronic alcohol intake

Answer 1

Alcoholism, like other forms of addiction, is a chronic brain disorder that, like other physical and mental disorders, does not have a cure. Still, medical and addiction treatment researchers continue to find ways to treat alcoholism, help people manage the disorder and achieve recovery, and prevent relapse. One main object of this research is the use of medications that make treatment and recovery easier and decrease the person’s desire to use alcohol.

Medication: Various medications are effective in reducing alcohol use after withdrawal: Naltrexone: opioid antagonist that reduces cravings for alcohol, reduces number of drinking days and the amount consumed in about 40-60% of patients. Avoid in those requiring opioid analgesia. Dose: 25mg for 2 days, increasing to 50mg once daily. Initiate 3 days after last drink. Acamprosate: works via glutamate pathways to reduce alcohol cravings. Dose: 666mg tds oral. Can initiate 3 days after last drink Disulfiram: alcohol dehydrogenase inhibitor: causes severe reaction (nausea, headache, abdo discomfort) if patient drinks alcohol. Requires motivated patient with dose supervision by carer. Consider written agreement with patient. Discuss with addiction specialist if liver or cardiac disease. Dose: 200mg per day. Initiate > 7 days after alcohol withdrawal, > 48 hrs after last drink Medications should not necessarily be discontinued following a lapse, but review treatment plan. Continue for at least 6 months if effective.

Types of Treatment

Behavioral Treatments

Behavioral treatments are aimed at changing drinking behavior through counseling. They are led by health professionals and supported by studies showing they can be beneficial.

Medications

Three medications are currently approved in the United States to help people stop or reduce their drinking and prevent relapse. They are prescribed by a primary care physician or other health professional and may be used alone or in combination with counseling.

Mutual-Support Groups

Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by health professionals, mutual-support groups can offer a valuable added layer of support.

Due to the anonymous nature of mutual-support groups, it is difficult for researchers to determine their success rates compared with those led by health professionals.

Starting With a Primary Care Doctor

For anyone thinking about treatment, talking to a primary care physician is an important first step — he or she can be a good source for treatment referrals and medications. A primary care physician can also:

• Evaluate whether a patient’s drinking pattern is risky
• Help craft a treatment plan
• Evaluate overall health
• Assess if medications for alcohol may be appropriate