Wednesday, 2 September 2015

Medication for alcohol use disorders

What medications treat alcohol use disorder?


There are few medications that are considered effective in treating moderate to severe alcohol use disorder. Naltrexone (Trexan, Revia, or Vivitrol) has been found effective in managing this illness. It is the most frequently used medication in treating alcohol use disorder . It decreases the alcoholic's cravings for alcohol by blocking the body's euphoric ("high") response to it. Naltrexone is either taken by mouth on a daily basis or through monthly injections. Disulfiram (Antabuse) is prescribed for about 9% of alcoholics. It decreases the alcoholic's craving for the substance by producing a negative reaction to drinking. Acamprosate (Campral) works by decreasing cravings for alcohol in those who have stopped drinking. Ondansetron (Zofran) has been found to be effective in treating alcohol use disorder in people whose problem drinking began before they were 25 years old. None of these medications have been specifically approved to treat alcoholism in people less than 18 years of age.Baclofen (Lioresal) has been found to be a potentially effective treatment to decrease alcohol cravings and withdrawal symptoms. Some research indicates that psychiatric medications like lithium(Eskalith, Lithobid) and sertraline (Zoloft) may be useful in decreasing alcohol use in people who have another mental-health disorder in addition to alcohol use disorder.

How can you tell if someone has a drinking problem?


Signs of a drinking problem include behaviors like drinking for the purpose of getting drunk, drinking alone or keeping it secret, drinking to escape problems, hiding alcohol in odd places, getting irritated when you are unable to obtain alcohol to drink, and having problems at work, school, home, or legally as a result of your drinking. Other warning signs of alcohol use disorder include losing interest in activities you used to enjoy, having blackouts because of heavy drinking, and getting annoyed when loved ones say you may have a drinking problem. Behaviors that may indicate that a person is suffering from alcoholism include being able to drink more and more alcohol, trouble stopping once you start drinking, powerful urges to drink, and having withdrawal symptoms like nervousness,nausea, shaking, or having cold sweats when you don't have a drink.

Can an alcoholic just cut back or stop drinking?


While some people with alcohol use disorder can cut back or stop drinking without help, most are only able to do so temporarily unless they get treatment. Individuals who consume alcohol in lower amounts and tend to cope with problems more directly are more likely to be successful in their efforts to cut back or stop drinking without the benefit of treatment.
Is there a safe level of drinking?

Recent research describes potential health benefits of consuming alcohol, including decreased risk of heart disease, stroke, and dementia. Given that, it is fair to say that low intake, along the lines of 4-8 ounces of wine per day, is likely safe.

Is it safe to drink alcohol while pregnant?


Babies who are born to mothers who are heavy drinkers are more at risk for being born with significant medical, developmental, behavioral, and emotional problems, including fetal alcohol syndrome (FAS). However, many babies whose mothers consumed even minimal amounts of alcohol during pregnancy have been born with such problems. Therefore, there is no amount of alcohol intake that has been proven to be safe during pregnancy.

What are the long-term physical and psychological effects of alcohol use disorder?


The long-term effects of alcohol use disorder can be devastating and even life-threatening. Chronic excessive alcohol consumption can negatively affect virtually every organ system. Specific examples of alcohol-use disorder effects on the body include everything from general effects like poor coordination,thiamine deficiency, and other forms of poor nutrition, cardiovascular effects like hypertension and irregular heartbeat, reproductive effects like impotence and irregular menses, as well asgastrointestinal problems likejaundice, cirrhosis of the liver, andpancreatitis. Alcohol-use disorder complications that involve the brain include, but are by no means limited to, strokes, confusion, and amnesia.

Approximately 10%-15% of people with alcoholism tend to commit suicide. Intoxication is associated with suicide attempts using more lethal methods, and positive blood-alcohol levels are often found in people who complete suicide. Men who have lost their spouses within the year are at highest risk of suicide.

What is codependency, and what is the treatment for codependency?


Codependency is the tendency to interact with another person in an excessively passive or caretaking manner that negatively affects the quality of the codependent individual's life. The codependent person has a pattern of putting their own needs below those of others, likely has low self-esteem, and tends to engage in denial, excessive compliance, and control. Individuals who are codependent are at risk for engaging in addictive behaviors, including alcoholism, drug or sexual addiction, as well as eating disorders or self-destructive or other self-defeating behaviors. Psychotherapy and participation in support groups are the usual treatments for codependency.

Is it possible to prevent alcohol use disorder?


Clear communication by parents about the negative effects of alcohol, as well as about their expectations regarding drug use, has been found to significantly decrease alcohol use in teens. Adequate parental supervision has also been found to be a deterrent to underage alcohol abuse. Alcohol, and other drug use, has been found to occur most often between the hours of 3 p.m. and 6 p.m., immediately after school and prior to parents' arrival at home from work. Teen participation in extracurricular activities has therefore been revealed to be an important prevention measure for the use of alcohol in this age group. Parents can also help educate teens about appropriate coping and stress-management strategies. For example, 15- to 16-year-olds who use religion to cope with stress tend to use drugs significantly less often and have fewer problems as a result of drinking than their peers who do not use religion to cope.

Factors for preventing alcohol use disorder in older teenagers and young adults include limiting the availability of alcohol and enforcing rules that address issues like drinking and driving. Specific examples of limiting the accessibility of alcohol might involve raising the cost of alcohol and restricting when and where alcohol can be consumed.

What is the prognosis of alcohol use disorder?


With treatment, about 70% of people with alcoholism are able to decrease the number of days they consume alcohol and improve their overall health status within six months. On the other hand, most individuals who have been treated for a moderate to severe alcohol-use disorder have relapsed at least once during the first year after treatment. Those individuals seem to drink less often and lower amounts after receiving treatment compared with before treatment.




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