The first and most important step in getting treatment for alcoholism is recognizing that you have a problem. Family members and close friends often convince persons with alcohol addiction to seek treatment.
Treatment and ongoing recovery must address both physical and psychological addiction, and may include inpatient treatment and/or Alcoholics Anonymous (AA). In an inpatient or residential program, the person generally stays in a hospital or center for 28 days, undergoing first detoxification (usually 4 to 7 days) and then individual and group therapy sessions that emphasize abstinence. Talk to a doctor about what is best for you or your loved one.
- Attend Alcoholics Anonymous.
- Family members should attend Al-Anon to learn how to help the person with the addiction and to get help and support themselves.
- Exercise regularly to help reduce cravings.
Your doctor may prescribe the following medications:
For alcohol withdrawal:
Benzodiazepines are tranquilizers used during the first few days of treatment to help you withdraw safely from alcohol. These drugs include:
- Diazepam (Valium)
- Chlordiazepoxid (Librium)
- Lorazepam (Ativan)
- Oxazepam (Serax)
Anticonvulsants may also help with withdrawal symptoms, and do not have the potential for abuse (as benzodiazepines do). They include:
- Carbamazepine (Tegretol)
- Valprioc acid (Depakote)
- Phenytoin (Dilantin)
- Gabapentn (Neurontin)
- Baclofen (Lioresal, Lioresal Intrathecal, Gablofen)
To prevent relapse:
Naltrexone (Revia, Vivitrol): It is used in combination with counseling. It may lessen the craving for alcohol, and help prevent a return to drinking. Taking Revia or Vivitrol blocks receptors in your brain so that you do not get "high" from drinking. It is only used after detoxification, which means it is only used after you are no longer physically addicted to alcohol.
Acamprosate (Campral): May help restore the chemical balance in the brain. It is best used in combination with counseling.
Disulfiram (Antabuse): It is an older medication that discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used.
Nutrition and Dietary Supplements
Because chronic use of alcohol decreases your appetite and keeps your body from absorbing vital nutrients, you may be deficient in a number of vitamins and minerals. Your doctor may tell you to take supplements while you are regaining your health. Beneficial supplements may include vitamin B complex, vitamin C, selenium, magnesium, and zinc. A combination of amino acids, such as carnitine, glutamine, and glutathione, may help reduce cravings, blood sugar fluctuations, and stress that is related to alcohol use.
Thiamine (vitamin B1): Your doctor may prescribe a thiamine supplement during withdrawal. Heavy use of alcohol causes thiamine deficiency, which can lead to a serious brain disorder called Wernicke-Korsakoff syndrome.
People who abuse alcohol are often deficient in vitamin A. Take supplements beyond the recommended daily allowance only under a doctor's supervision. High doses of vitamin A can damage the liver, and may cause alcoholic liver disease to develop more quickly in people who drink heavily.
Some members of the alcohol recovery community recommend a heavier, nutritionally-oriented approach. This includes intravenous (IV) nutritional therapies, along with targeted amino acid supplementation, to modulate brain function. The mainstream alcoholism treatment community considers some of these approaches controversial, so make sure you work with a reputable doctor and update every member of your recovery team on the type of therapies you are using.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider. However, you should not use herbs alone to treat alcoholism. Counseling and peer groups such as AA are also needed.
- Milk thistle (Silybum marianum): Milk thistle is often used to treat liver problems. Some studies looking at milk thistle to treat alcoholic liver disease have found significant improvements in liver function. People with the mildest form of alcohol-related liver damage seem to improve the most. Milk thistle is less effective for those with severe liver disease, such as cirrhosis, which is characterized by scarring and permanent, irreversible damage to the liver. However, there are no studies looking at whether milk thistle is useful for alcohol withdrawal. Some compounds in milk thistle may resemble estrogen in their composition, so people with hormone-sensitive conditions should speak to their doctor.
- Kudzu (Pueraria lobata): Animal studies suggest that kudzu, used in traditional Chinese medicine to treat alcohol abuse, might help reduce cravings. Human studies are mixed. One study in humans failed to show any benefit, while another found that heavy drinkers who had taken kudzu supplements for 7 days drank significantly less beer when given the opportunity than heavy drinkers who had taken a placebo. Kudzu can interact with many medications, including blood thinners, methotrexate, diabetes medications, and estrogens.
- Dandelion (Taraxacum officinale): Dandelion is used traditionally for liver-related problems, although there is evidence that it helps alcohol withdrawal symptoms. It is often combined with milk thistle. Dandelion can interact with many medications, including lithium.
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend a treatment for alcoholism based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual. Homeopathy alone should not be used to treat alcoholism, but can be a supportive therapy along with counseling and groups such as AA. The following are a few examples of remedies that an experienced homeopath might consider for symptoms related to alcohol abuse or withdrawal:
Arsenicum album: For anxiety and compulsiveness, with nausea, vomiting, and diarrhea
Nux vomica: For irritability and compulsiveness with nausea, vomiting, and constipation
Lachesis: For alcohol cravings, headaches, and difficulty swallowing
Staphysagria: For angry individuals who tend to suppress their emotions and may have been abused physically, sexually, or psychologically in the past
Cognitive behavioral therapy with a psychologist or psychiatrist is a very effective treatment approach for alcohol addiction. This type of therapy, which is geared toward changing your beliefs and thought process about drinking, can help you cope with stress and control your behavior. Talk to your doctor about finding a qualified cognitive behavioral therapist.
In some cases, acupuncture may be a useful supportive therapy for addiction. Some, but not all studies of acupuncture for the treatment of alcohol abuse have shown that it can reduce cravings and symptoms of withdrawal. However, acupuncture alone should not be used to treat alcohol addiction, but it may be used in combination with counseling and groups such as AA.
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