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Treatment for alcohol dependency

Some medical inpatients with unhealthy alcohol use may benefit from a brief intervention, say researchers from Boston University School of Medicine.

The first step for the alcoholic it to acknowledge that there is an alcohol dependency problem. The next step is to get help. In most of the world there are several support groups and professional services available.

A study found that people with a stable psychosocial life situation often delay in seeking help for their alcohol problems even though they are serious.

  • Do-it-yourself - experts say about 30% of people with an alcohol problem manage to reduce their drinking or abstain without seeking professional help. There is a great deal of material in books and the internet that may help the self-helper.

  • Counseling - a qualified counselor can help the alcoholic talk through his/her problems and then devise a plan to tackle the drinking. CBT (cognitive behavioral therapy) is commonly used to treat alcohol dependency.

  • Treating underlying problems - the alcoholic may have a problem with self-esteem, stress, anxiety, depression, or some other mental health problem. It is important to treat these problems too. It is crucial for the alcoholic to realize that drinking will probably make mental health problems worse. As alcoholics commonly suffer from hypertension, liver diseases, and possibly heart diseases, these will need to be treated too.

  • Residential programs - residential programs are ideal for some people. They include expert professional help, individual or group therapy, support groups, training, family involvement, activity therapy, and a host of strategies that are aimed at treating the alcoholic successfully. Some people find that being physically away from access to temptation is a great help.

  • Drug that provokes a severe reaction to alcohol - Antabuse (disulfiram) causes a severe reaction when somebody drinks alcohol, including nausea, flushing, vomiting and headaches. It is a deterrent. It will not treat the alcoholic's compulsion and will not cure alcoholism.

  • Drugs for cravings - Naltrexone (ReVia) may help with the urge to have a drink. Acamprosate (Campral) may help with cravings.

  • Hormone ghrelin - Researchers at the Sahlgrenska Academy, Gothenburg, have discovered a new brain mechanism involved in alcohol addiction involving the stomach hormone ghrelin. When ghrelin's actions in the brain are blocked, alcohol's effects on the reward system are reduced. It is an important discovery that could lead to new therapies for addictions such as alcohol dependence.

  • Detoxification - the patient takes some medication to prevent withdrawal symptoms (delirium tremens) which many alcoholics experience when they give up drinking. Treatment usually lasts from four to seven days. Chlordiazepoxide, a benzodiazepine medication, is frequently used for detoxification (detox). Doses will be initially high, and will then taper off. It is important that the patient abstains completely from alcohol during the detox.

  • Staying on the wagon (remaining abstinent) - some patients find the detox acheivable, but start drinking again soon after, or some time later. It is important to remember Samuel Johnson's phrase "If at first you don't succeed. Try, try, and try again." Success rates are significantly improved if the patient has access to counseling or some support group. Family support is crucial. Sometimes a good GP can provide vital support. A study found that genetics is a factor in predicting the risk of relapse among alcohol-dependent patients.

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