TREATMENT - OPTIONS FOR ALCOHOLISM

Alcoholism treatment varies widely from one center to another because there are many different viewpoints on the nature of the condition itself. Those There are those who consider that treatment for alcoholism should proceed along medical lines. Others consider treatment for social choice. Yet other approach the condition as a physical or genetic anomaly

Most treatment programs place major emphasis on assisting people to limit or preferably ti discontinue the intake of alcoholic beverages, succeeded by reeducating on social behavior and also make use of support mechanism so that they will be reluctant to turn to alcohol in the future.

Typical regimens for most programs will consist of detoxification, therapy, self-help groups and development of coping mechanisms. Most programs promote zero tolerance, although there are a few who teach harm reduction.

The potency of treatments for alcoholism differs greatly. When considering how to rate effectiveness, several factors should be considered, including the statistics not only at the close of the program but the same figures one year after completing a rehabilitation program.

Ordinarily the first step in treatment for alcoholism is detoxification. This consists of cessation of alcohol intake combined with the use of medications which partially offset the symptoms of withdrawal. The most common medication used for this purpose is Benzodiazeprine. The purpose of detoxification is to allow time for the toxins or poisons which have accrued in the tissues and cells of the body to be excreted from the body. Detoxification is not considered therapy, just a way to allow the patient to begin the process of therapy with the least possible discomfort. Detoxification is not necessary in every situation; the health, age and drinking patterns are taken into consideration in making the determination for or against it.

There are multiple ways in which to complete detoxification. A standard dose of the medication benzodiazeprine is given every half hour until the patient is lightly sedated. This level is considered the baseline dosage. From that point the medication is gradually reduced over the next three to ten days. A second method of detoxification is to start with a standard dosage of the medication and adjust it according to the withdrawal symptoms displayed. A third option is possible when there is only mild usage of alcohol and that is to delay giving the medication until the symptoms begin. This is the least safe method.

Once detoxification has been completed, typically the patient is exposed to various types of psychotherapy or group therapy in order to assist him in dealing with deep psychological and emotional issues that are associated with addiction to alcohol in order to teach skills which will make relapse unlikely.

Support group counseling and help is one of the ways alcoholics use in order to help maintain abstinence. Some of the groups which provide group counseling include Women for Sobriety, Al-Anon/Alateen, Smart Recovery, Rational Recovery, Secular Recovery, LifeRing, and Alcoholics Anonymous
Moderation programs such as Moderation Management don't push complete abstinence, although the National Institute on Alcohol Abuse and Alcoholism shows that nearly 18% of alcohol dependent people went back to low-risk alcohol consumption.

Several types of medications are routinely prescribed during the course of treatment. Two basic types are given, those which make detoxification less traumatic and those who create physical distress when the addict attempts to drink while taking the medications. The most common types of medications include:

l Antabuse prevents elimination of the chemical acetaldehyde which is the cause of most of the symptoms of hangover from alcohol use. When this medication is taken with alcohol it acts like a long-lasting and uncomfortable hangover. Heavy drinking while on antabuse are risking severe illness and death

l Naltrexone lessons alcohol cravings which helps to encourage abstinence and also can be used to reverse endorphin conditioning, one of the causative factors for addiction.

l Piracetam works on the levels of lipofuscin. Excess accumulation of lipofuscin has been linked to both aging and alcoholism.

l The reason for the effectiveness of Acamprosate or Campral is not fully understood, but is believed to reduce glutamate release and is effective for short term abstinence treatment.

l Sodium oxybate and Baclofen are both used for detoxification and for acute alcohol withdrawal symptoms.

The Sinclair Method uses a naltrexone treatment which removes the beneficial effect of endorphins over about a three month period. The alcoholic is encouraged to continue their normal drinking habits while at the same time taking naltrexone. The medications negates the endorphins release over the neurons thus eliminating the 'feel good' results from drinking. There is a significant amount of resistance from professionals for this treatment, first because drinking in moderation or controlled drinking is not considered to be a useful path to follow for alcoholics and secondly because studies don't confirm that naltrexone by itself is useful for supporting abstinence. However, the presence of naltrexone appears to decrease enjoyment of alcohol consumption which presumably will lead to reduced consumption.

Nutritional therapy is a good adjunct to standard remedies for alcoholism. While this type of therapy doesn't help cure alcoholism, it does help to prevent further health complications which have come about due to alcohol usage. Typical supplements provided are vitamins B12 and folate in multivitamin format. It is fairly typical for those who are alcohol dependent to have insulin resistance syndrome. Technically, this is a disorder of the metabolic system where there is difficulty in processing sugars, so the supply of sugar to the blood stream is unstable. A person who has the disorder can usually be helped by following a hypoglycemic diets, but they often show affects on both emotions and behavior. It is easy to overlook metabolic imbalances which have resulted from alcohol dependency when establishing a long term treatment program, but this can result in a poor showing for long term abstinence.

It's important to remember that treatment for alcohol abuse shouldn't end with release from the program or residential center. It is most effective when it bridges the gap between a residential treatment center and the typical stresses found in the work-a-day world.