How to deal with Alcohol Addiction

I will only touch on the treatment of alcohol addiction for the health blog. It is a long and hard process and a person must want to give up alcohol to be successful. Call into Whelehans Pharmacy for more detailed information or check www.whelehans.ie. All information is free and is confidential. Treatment depends on the amount of alcohol a person is drinking. Treatment options include detoxification, medication and counselling. Abstinence is the best and most successful approach to beat alcohol addiction.

Detoxification

In mild cases, detox can be done at home without the use of medication because withdrawal symptoms should be mild. If consumption of alcohol is high (over 20 units a day) or withdrawal symptoms were previously experienced, detox at home with medication to help ease withdrawal symptoms may be possible. A short course of a tranquiliser called chlordiazepoxide (Librium^®) is usually prescribed in this case (for about 5 days). If dependency is severe, detox at a hospital or clinic may be required as withdrawal symptoms will be severe.  

Withdrawal symptoms

Withdrawal symptoms are worst for the first 48 hours. They gradually start to improve as the body begins to get used to being without alcohol. This usually takes 3-7 days from the time of the last drink. Sleep will be disturbed. Sleep patterns often start to return to normal within a month. During detox, it is important to drink plenty of fluids (about three litres a day). Avoid drinking large amounts of drinks containing caffeine like tea and coffee as caffeine exacerbates sleep problems and cause feelings of anxiety. Stick with water, squash or fruit juice to re-hydrate. Try to eat regular meals even if not feeling hungry. Normal appetite will return gradually. Withdrawal from alcohol is an important first step; further treatment and support will be needed as it is a long term struggle to stay dry.

 Medication

The three most common drugs used to treat alcohol addiction are acamprosate, disulfiram and naltrexone.

 Acamprosate

Acamprosate (brand name Campral^®) is used to help prevent a relapse in people who have successfully given up alcohol and works by helping reduce craving. Acamprosate works by blocking a chemical in the brain called gamma-amino-butyric acid (GABA). GABA helps cause a craving for alcohol. Acamprosate is usually started as soon as withdrawal from alcohol begins and can be prescribed for up to six months. I will discuss the other drugs used to treat alcohol addiction and other counseling options next week.

Disulfiram

Disulfiram (brand name Antabuse^®) is a drug that may be tried if trying to achieve abstinence if relapse is a possibility. Disulfiram works by causing unpleasant physical reactions if alcohol is consumed thus acting as a deterrent. These can include nausea, chest pain, vomiting, flushed skin and dizziness. Unpleasant reactions can occur if the person comes into contact with alcohol for a week after finishing taking disulfiram, so it's important to avoid alcohol for a week after stopping disulfiram.

Naltrexone

Naltrexone works by reducing the enjoyment someone gets from alcohol thus reducing drinking or helping someone give it up completely. It works by blocking the opioid receptors in the body, stopping the effects of alcohol. It's usually used in combination with other medicine or counselling. Naltrexone should only be prescribed by a specialist in alcohol dependence.

Counselling

Self-help groups

Alcoholics Anonymous (AA) is a great support to many fighting alcohol dependence. The core belief behind AA is that alcoholic dependence is a long-term condition and total abstinence is the only solution. AA has a 12-step programme designed to help overcome addiction. It includes the following steps •Admitting a powerlessness over alcohol and that a normal fulfilled life with alcohol is impossible. •Realising that you cannot fight the addiction without support. •Examining past errors with the help of a sponsor (an AA member who has been through it before). •Making amends for errors made. •Living a new more fulfilled life without alcohol and improving behaviour. •Helping others who are going through the same addiction problems

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) uses a problem-solving approach to alcohol dependence.  CBTs approach to alcohol dependence is to identify and deal with unhelpful and unrealistic thoughts and beliefs that contribute to continual drinking such as: •"I can't relax without alcohol." • “all my friends drink” • “I can’t enjoy a social occasion without alcohol” •"Just drinking one pint can’t hurt."

The idea of CBT is to change these unhelpful thoughts and perceptions to: •"I can have a good time without alcohol" • “I don’t need the hassle of feeling miserable with hangovers” • “I will join new clubs and societies that don’t involve alcohol to make new friends that I can meet without having to drink”  •"I know I can't stop drinking once I start." Other types of therapy include Extended Brief Intervention and Family Therapy

Community Alcohol and Drug Service (CADS)

The HSE Community Alcohol and Drug Service offer counselling and treatment services for adults suffering from addiction to alcohol, drugs and gambling. CADS have centres in Mullingar, Athlone and Longford. CADS provides counselling and treatment to help people get over their addiction and offer support and counselling to family members. All services are totally confidential. You can refer yourself to the service directly. If you have a loved one or someone you know that could avail of this service you can contact CADS to discuss your options. All referrals must be made with the consent of the person being referred. You can contact their Mullingar centre at 04493 41630.

Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended

This article is shortened for this health blog. More detailed information and leaflets is available in Whelehans or www.whelehans.ie