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Effective Options for Treating Alcohol Dependency

No simple and universally effective cure has yet been developed for alcohol dependency. However, the combination of a variety of approaches – including individual counseling; group, family, and marital counseling; certain medications; behavior modification; participation in recovery support groups (such as Alcoholics Anonymous) and ongoing, structured aftercare – has proved to be an effective means of helping alcoholic individuals regain control over their behaviors.

A chronic, progressive, and potentially lethal disorder, alcoholism can wreak considerable damage on an individual’s health, social development, academic/professional performance, and ability to maintain positive interpersonal relationships. It also has a dramatic negative (and expensive) effect on society as a whole, with costs related to alcohol-related medical issues, accidents, and decreased workplace productivity totaling in the tens of millions of dollars every year.

The U.S. Food and Drug Administration (FDA) offers the following alcoholism-related information on its website:

Based on the American Psychiatric Association's 4th edition of Diagnostic and Statistical Manual of Mental Disorders, [the National Institute on Alcohol Abuse and Alcoholism] recognizes four signs of alcoholism:

  • Loss of control over drinking. Alcoholics may intend to have two or three drinks, but before they know it, they are on their 10th.
  • Continued use of alcohol despite social, medical, family, and work problems.
  • Increased alcohol tolerance over time--that is, needing more alcohol to become intoxicated.
  • Withdrawal symptoms when alcoholics stop drinking after a period of heavy drinking. The symptoms include anxiety, agitation, increased blood pressure, and, in extreme cases, seizures. These symptoms may persist for several days.

People do not need to have all four signs to be diagnosed as alcoholic. Those who have significant problems controlling their drinking and functioning in social situations because of alcohol may be considered alcoholics without the physical signs, tolerance and withdrawal.

The good news is that millions of Americans have overcome the challenge of alcoholism and have resumed healthy lifestyles and the pursuit of their greatest potential.

To assist patients who are experiencing withdrawal symptoms, the FDA has approved two anti-anxiety drugs: Valium (diazepam) and Librium (chlordiazepoxide). The FDA’s website describes the effects of these drugs in the following manner:

These drugs help decrease the symptoms of alcohol withdrawal, including anxiety and tremors, and reduce the risk of serious consequences of withdrawal, such as seizure and delirium. Dosages are based on the severity of patients' symptoms.

Use of these drugs beyond the withdrawal phase is not advised for alcoholics because of the drugs' abuse potential and alcoholics' addictive inclination.

The FDA has also approved the following medications for patients whose health care providers determine that their disorders merit their use:

Acamprosate –Acamprosate (also known as Campral) was approved for use in the United States in 2004. The release that announced the approval of Acamprosate included the following:

Campral is thought to act on the brain pathways related to alcohol abuse. Campral was demonstrated to be safe and effective by multiple placebo-controlled clinical studies involving alcohol-dependent patients who had already been withdrawn from alcohol, (i.e., detoxified).

Antabuse – Antabuse was the first alcohol dependence drug to be approved by the FDA for use by alcoholic patients in the United States. Also known as disulfiram, Antabuse is prescribed to people who have not yet been able to quit drinking, and works by causing a severe negative reaction when a person who is taking it consumes alcohol.

Research is currently being conducted on disulfiram’s efficacy in the treatment of cocaine addiction, as well as for some types of cancer.

Naltrexone – Marketed under the brand names Revia, Depade, and Vivitrol,” Naltrexone reduces cravings for alcohol. The drug is also used in “rapid detoxification,” during which patients are often sedated or placed under general anesthesia.

According to the NIAAA, results from the five-year Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study demonstrated that “Naltrexone and up to 20 sessions of alcohol counseling by a behavioral specialist are equally effective treatments for alcohol dependence when delivered with structured medical management.”

Continued research into medications for alcoholism, according to the FDA, is focused on the following objectives:

  • To induce sobriety in intoxicated patients
  • To treat long-lasting withdrawal symptoms, which often lead to relapse
  • To control alcohol craving
  • To improve mental abilities of patients with alcohol-induced mental damage
  • To decrease alcohol consumption by treating coexisting psychiatric disorders.
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