Alcoholism
Alternative names:
alcohol dependence; habitual alchohol use
Treatment:
Treatment for the person with alcohol dependence begins with the recognition of the problem. Alcoholism is associated with denial, allowing the person to believe there is no need for treatment. Most people with alcohol dependence enter treatment under pressure from others rather than voluntarily accepting the need for treatment. Penetration of the defense mechanisms that have allowed the person with alcohol dependence to continue drinking is difficult, and involves confrontation by the family or people close to the affected person who are aware of the problem. The person should be confronted when sober, not while drinking or recovering from a drinking episode. Once the problem has been recognized, total abstinence from alcohol is the only effective treatment. Supportive programs are available to offer detoxification, rehabilitation, and aftercare or follow-up. Because alcoholism creates victims of people associated closely with the alcoholic, treatment for family members through counseling is often necessary.
Detoxification is the first phase of treatment. Alcohol is withdrawn under a controlled, supervised setting. Tranquilizers and sedatives are often prescribed to control alcohol withdrawal symptoms. Detoxification usually takes 4 to 7 days. Examination for other medical problems is necessary. Liver disease and blood clotting problems are common. A balanced diet with vitamin supplements are important. Complications associated with the acute withdrawal of alcohol may occur, such as DT's. Depression or other underlying mood disorders should be treated. Often, alcohol abuse develops from efforts to self-treat an illness.
Alcohol recovery or rehabilitation programs support the affected person after detoxification to maintain abstinence from alcohol. Counseling, psychological support, nursing, and medical care are usually available within these programs. Education about the disease of alcoholism and its affects is part of the therapy. Many of the professional staff involved in rehabilitation centers are recovered alcoholics who serve as role models.
Aversion or deterrent therapy uses a drug that interferes with alcohol metabolism and produces very unpleasant side effects if even a small amount of alcohol is ingested within 2 weeks after taking the drug. Aversion therapy is not given in pregnancy or with certain medical conditions. This therapy may be used with supportive counseling or alone, and effectiveness varies.
Alcoholics Anonymous is a self-help group of recovering alcoholics that offers emotional support and an effective model of abstinence for people recovering from alcohol dependence. There are more than 1 million members worldwide, and local chapters are found in small towns and large cities throughout the US.
Al-Anon is a support group for spouses and others who are affected by someone else's alcoholism. Alateen provides support for teenage children of alcoholics. See alcoholism - support group.
Expectations (prognosis):
Alcoholism is a major social, economic, and public health problem. Alcohol is involved in more than half of all accidental deaths and almost half of all traffic fatalities. A high percentage of suicides involve the use of alcohol in combination with other substances. Additional deaths are related to the long-term medical complications associated with the disease. Only 15% of those with alcohol dependence seek treatment for this disease. Treatment programs have varying success rates, but many people with alcohol dependency have a full recovery.
Complications:
Calling your health care provider:
Go to the emergency room or call the local emergency number (such as 911) if severe confusion, seizures, bleeding, or other health problems develop in a person known or suspected to have alcohol dependence.
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