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Alcoholism Treatment

Signs and symptoms of Alcoholism: Most alcoholics deny that they have a drinking problem. Other indications of alcoholism and alcohol abuse include:

  • Drinking alone or in secret
  • Being unable to limit the amount of alcohol you drink
  • Not remembering conversations or commitments, sometimes referred to as "blacking out"
  • Making a ritual of having drinks before, with or after dinner and becoming annoyed when this ritual is disturbed or questioned
  • Losing interest in activities and hobbies that used to bring pleasure
  • Feeling a need or compulsion to drink
  • Irritability when your usual drinking time nears, especially if alcohol isn't available
  • Keeping alcohol in unlikely places at home, at work or in the car
  • Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel normal
  • Building a tolerance to alcohol so that you need an increasing number of drinks to feel alcohol's effects
  • Experiencing physical withdrawal symptoms such as nausea, sweating and shaking if you don't drink

People who abuse alcohol may experience many of the same signs and symptoms as people who are dependent on alcohol. However, alcohol abusers don't feel the same compulsion to drink and usually don't experience physical withdrawal symptoms when they don't drink. A dependence on alcohol also creates a tolerance to alcohol and the inability to control your drinking.

If you've ever wondered if your own alcohol consumption crosses the line of abuse or dependence, ask yourself these questions:

  • Do you need a drink as soon as you get up?
  • Do you feel guilty about your drinking?
  • Do you think you need to cut back on your alcohol consumption?
  • Are you annoyed when other people comment on or criticize your drinking habits?

If you answered yes to two or more of the above questions, it's likely that you have a problem with alcohol. Even one yes answer may indicate a problem.

Causes of Alcoholism: Alcohol addiction (physical dependence on alcohol) occurs gradually as drinking alcohol alters the balance of some chemicals in your brain, such as gamma-aminobutyric acid (GABA), which inhibits impulsiveness, and glutamate, which excites the nervous system. Alcohol also raises the levels of dopamine in the brain, which is associated with the pleasurable aspects of drinking alcohol. Excessive, long term drinking can deplete or increase the levels of some of these chemicals, causing your body to crave alcohol to restore good feelings or to avoid negative feelings.

Alcoholism Risk factors Steady drinking over time can produce a physical dependence on alcohol. Drinking more than 15 drinks a week for men or 12 drinks a week for women increases the risk of developing dependence on alcohol. However, drinking by itself is just one of the risk factors that contribute to alcoholism. Other risk factors include:

  • Age. People who begin drinking at an early age by age 16 or earlier are at a higher risk of becoming an alcoholic.
  • Genetics. Your genetic makeup may increase your risk of alcohol dependency.

Alcoholism Treatment Most alcoholics and alcohol abusers enter treatment reluctantly because they deny that they even have a problem. Health problems or legal difficulties may prompt treatment. Intervention helps some alcoholics recognize and accept the need for treatment. If you're concerned about a friend or family member, discuss intervention with a professional.

Various treatments are available to help people with alcohol problems. Depending on the circumstances, treatment may involve an evaluation, a brief intervention, an outpatient program or counseling, or a residential inpatient stay.

The first step in alcoholism treatment is to determine whether you are dependent on alcohol. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you're dependent on alcohol, simply cutting back is ineffective. Abstinence must be part of your treatment goal.

If you aren't dependent on alcohol but are experiencing the adverse effects of drinking, the goal of treatment is to reduce alcohol-related problems (often through counseling or a brief intervention), which usually involves alcohol abuse specialists who can establish a specific treatment plan. Interventions may include goal setting, behavioral modification techniques, use of self help manuals, counseling and follow up care at a alcoholism treatment center.

Residential treatment programs Many residential alcoholism treatment programs in the U.S. include abstinence, individual and group therapy, participation in Alcoholics Anonymous (AA), educational lectures, family involvement, work assignments, activity therapy and the use of counselors (many of whom are recovering alcoholics themselves) and a professional staff.

Here is what you might expect from a typical residential treatment program:

  • Detoxification and withdrawal. Treatment may begin with a program of detoxification, usually taking about four to seven days. You may need to take sedating medications to prevent delirium tremens or other withdrawal seizures.
  • Medical assessment and treatment. Common medical problems related to alcoholism are high blood pressure, increased blood sugar, and liver and heart disease.
  • Psychological support and psychiatric treatment. Group and individual counseling and therapy support recovery from the psychological aspects of alcoholism. Many treatment programs also offer couples and family therapy because family support can be an important part of the recovery process. In fact, involving a spouse in the treatment process may increase the chances of a successful recovery.
  • Emphasis on acceptance and abstinence. Effective treatment is impossible unless you accept that you're addicted and unable to control your drinking.
  • Drug treatments. An alcohol-sensitizing drug called disulfiram (Antabuse) may be a strong deterrent. Disulfiram won't cure alcoholism nor can it remove the compulsion to drink. But if you drink alcohol, the drug produces a severe physical reaction that includes flushing, nausea, vomiting and headaches. Naltrexone (ReVia), a drug long known to block the narcotic high, also reduces a recovering alcoholic's urge to drink. Acamprosate (Campral) is an anti-craving medication that may help you combat alcohol cravings and remain abstinent from alcohol. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick soon after taking a drink.
  • In June 2006, the Food and Drug Administration (FDA) approved the first injectable drug to treat alcohol dependence. Vivitrol, a version of the drug naltrexone, is injected in the buttocks once a month by a health care professional. It may reduce the urge to drink by blocking neurotransmitters in the brain thought to be associated with alcohol dependence. Vivitrol doesn't affect alcohol withdrawal symptoms. It's intended for alcoholics in counseling who haven't had a drink for at least a week. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol dependence to use consistently.
  • Continuing support. Aftercare programs and AA help recovering alcoholics abstain from alcohol, manage relapses and cope with necessary lifestyle changes.

Alcohol Detoxification Alcohol detoxification is a process often necessary when a person has been consuming alcohol for long periods of time. In order to live sober, ever alcoholic must endure a detox period. Alcohol detoxification can be uncomfortable, and alcoholics can often be plagued by withdrawal symptoms. It is strongly recommended that detox be done under the direct supervision of an alcohol treatment facility or sober living home.

The most important reason that alcohol detoxification must be supervised by a professional is that withdrawal can be fatal. Alcoholics become so habituated to the presence of alcohol in the system that when it is removed, the body can react strongly. Feelings of nausea and even convulsions may occur. At a treatment facility or sober living home, a great emphasis is placed on withdrawal management during detoxification.

Goal of Alcohol Detox The goal of alcohol detox is to achieve a life completely free of alcohol abuse. The objective of detox is to alleviate the physical symptoms of withdrawal.

Once the detoxification process is complete, the process of psychological rehabilitation begins. This may include AA meetings, therapy or one on one meetings. Often times, addictive behavior begins for one reason, but continues for many others. For example, alcohol can initially be used as a social lubricant, but eventually transition into a stress reliever or a distraction from life problems. Using alcohol to avoid problems usually worsens issues, whether they be legal, work related, or relationships. Without the alcohol detoxification, this true healing cannot begin.

Symptoms of Alcohol Detox Mild reactions to alcohol detoxification include:

  • Tremors
  • Headaches
  • Vomiting
  • Perspiration
  • Restlessness
  • Loss of appetite
  • Insomnia

Severe effects of alcohol detox include:

  • Delirium Tremors (DTs)
  • Autonomic Hyperactivity
  • Convulsions

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