Conventional Alcoholism Treatment
For some alcoholics, treatment begins with “detoxification”–that is, medical management of acute alcohol withdrawal. This can be done in the hospital or on an outpatient basis and usually lasts one to seven days.
FDA has approved two anti-anxiety drugs, Valium (diazepam) and Librium (chlordiazepoxide), for treating alcohol withdrawal effects. Some doctors also prescribe other drugs in the same chemical class, also approved to treat anxiety. These drugs help decrease the symptoms of alcohol withdrawal, including anxiety and tremors, and reduce the risk of serious consequences of alcohol withdrawal, such as seizure and delirium. Dosages are based on the severity of patients’ symptoms. Use of these drugs beyond the alcohol withdrawal phase is not advised for alcoholics because of the drugs’ abuse potential and alcoholics’ addictive inclination. Because heavy drinking often results in nutritional deficiencies, vitamins, particularly thiamin and other B vitamins, also may be given.
Once sober, patients can begin their alcohol rehabilitation. Many enroll in hospital-based or freestanding alcoholism treatment centers. While enrolled, patients attend classes, hear lectures, and participate in individual, group and family counseling sessions. The activities aim to educate patients about alcoholism, help them recognize that they have the disease, and help them adjust to a life without alcohol. Patients often are introduced to self-help groups, such as AA (alcoholics anonymous). Family members often get involved, too, and may be referred to Al-Anon, a self-help group for family members of alcoholics. Following this intensive program, patients are often encouraged to continue with some type of aftercare program for at least one year. This might include AA (alcoholics anonymous), individual or group psychotherapy, or a center-sponsored program that continues on a smaller scale the same type of activities offered during the intensive alcohol treatment.
Drug Treatment
Alcoholics also may be helped in their recovery with one of two drugs approved for discouraging alcohol intake. Antabuse (disulfiram), sold by Wyeth-Ayerst Laboratories Division, has been marketed since 1948. When combined with alcohol, even small amounts, this drug causes unpleasant effects, such as facial flushing, throbbing headache, nausea, vomiting, and increased blood pressure and heart rate.
The drug’s effectiveness depends on patient motivation. Those who want to drink simply stop taking the drug. A 1986 study found that Antabuse did not improve abstinence rates, length of time to relapse, or psychosocial functioning any more than counseling alone. But, patients on Antabuse who continued to drink drank less frequently than relapsed patients who did not receive the medication.
The second drug, ReVia (naltrexone), approved by FDA in December 1994 for treating alcoholism, acts on the opioid receptor in the brain to help prevent relapse and reduce alcohol cravings in those who drink. ReVia was developed by The DuPont Merck Pharmaceutical Co., which previously marketed naltrexone under the trade name Trexan for treating narcotic dependency. The drug remains available for treating narcotic dependency but under the new brand name, ReVia. In a 12-week study of 70 alcoholic men, 23 percent of the ReVia-treated patients relapsed, compared with 54 percent of those receiving placebo. Of those who drank during the study, 50 percent of those on ReVia relapsed to heavy drinking, compared with 95 percent of those receiving placebo.
If you are looking for an alcohol rehab program or alcohol detox program call the national alcoholism helpline at 1-800-99-DETOX.
A study of 104 alcoholic men and women found that patients who took ReVia were about twice as successful in quitting drinking as patients who received placebo. However, because ReVia was tested in conjunction with supportive therapy, FDA approved its use only as an adjunct to supportive therapy (such as group therapy) in treating alcoholism.
Studies show the drug is nonaddictive. But it can cause liver toxicity when given at doses higher than recommended. Therefore, it is not recommended for people with active hepatitis and other liver diseases. NIAAA is sponsoring additional studies to determine which patients are best suited for drug treatment with ReVia, as well as what dose, therapy combinations, and treatment duration work best.
Research Continues
Though treatments are helping make controlling alcoholism easier, a cure is more elusive. The disease of addiction is so complex, that it may be unlikely one single drug to treat alcoholism will be discovered. Instead, he said, research will continue to focus on finding drugs that can treat various aspects of alcoholism.
Current NIAAA research efforts focus on developing drugs to:
- Induce sobriety in intoxicated patients
- Treat long-lasting withdrawal symptoms, which often lead to relapse
- Control alcohol craving
- Improve mental abilities of patients with alcohol-induced mental damage
- Decrease alcohol consumption by treating coexisting psychiatric disorders
But the advent of these drugs is not likely to diminish the importance of behavioral therapies. Self-help programs, like AA (alcoholic anonymous), will continue to play an important role for many alcoholics.
Please do not hesitate in contacting us for more information at our drug addiction treatment information website www.recoveryconnection.org or calling our 24/7 alcohol and drug abuse helpline 1-800-993-3869.
