Medications Can Aid Recovery from Alcoholism : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 3)

A study in a 1992 Journal of Studies on Alcohol (Volume 53, Number 2) suggests there may be a third type similar to Type II but without the antisocial behavior.

People often realize a friend or family member has alcoholism through the consequences of drinking, such as arrests for drunk driving or problems at work, including chronic absenteeism. Alcoholics' spouses may demand they leave the house. Later in the disease, they may be hospitalized for liver disease or pancreatitis.

Denial of these and other negative effects of alcohol in their lives is common in alcoholics and those close to them, according to the National Council on Alcoholism and Drug Dependence. But sometimes the negative occurrences can serve as a catalyst for getting the alcoholic into treatment. More usually, an ultimatum from the spouse or other family member, boss, doctor, or judge is the driving force.

McCrory sought treatment after his wife, son and daughter told him he needed help. A bout with acute pancreatitis (inflammation of the pancreas) also helped convince him. "The pains were so severe, I wanted to die," he said. "I never want to go through that again."

Conventional 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 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.

Because heavy drinking often results in nutritional deficiencies, vitamins, particularly thiamin and other B vitamins, also may be given.

Once sober, patients can begin rehabilitation. Many enroll in hospital-based or freestanding alcoholism treatment centers. According to a 1991 survey by the U.S. Department of Health and Human Services, nearly 575,000 people were treated in 8,298 facilities in the United States on Sept. 30, 1991. Of those, 12 percent were treated as inpatients, 88 percent as outpatients.

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. 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, individual or group psychotherapy, or a center-sponsored program that continues on a smaller scale the same type of activities offered during the intensive treatment.

For example, at an addiction treatment center in Bethesda, Md., aftercare consists of a 15-week program, in which participants meet twice a week for one hour. They hear lectures and participate in group therapy. This is followed by ongoing group therapy of up to one year for patients with a history of relapse.

"This is a powerful enough disease that a great number of people are going to [drink] one more time, at least," said Larry Goodwin, a licensed social worker and director of the Addiction Treatment Center at Montgomery General Hospital in Olney, Md. "And sometimes that's a necessary part because they find out, 'I don't like the results. I've tried it again, and [the experts] are right.'"

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.

About the Author

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