Substance
abuse is a globally recognized major mental health problem. Alcohol addiction
known as alcohol dependence is a problem with humanity since the discovery of
euphoric nature of alcohol. Almost all addicts get into the problem for
experimental reasons. Initially for kick but later to escape from physical
problems associated with state without alcohol.
What is alcohol or about alcohol?
Chemically it is ethyl alcohol and a substance of abuse.
What is dependence (addiction)?
Many people
take alcohol but are not dependent on alcohol. However they are too are abusing
alcohol and can slip into dependence any time. However dependence or addiction
is a crippling state which grossly lowers the quality of life of a patient.
Medically dependence is defined as fulfilling of three or more criteria in a
year’s period-
1. Tolerance- it is the need for more
amount of alcohol to get same intoxication as used to get in smaller amounts
earlier.
2. Craving-urge to drink alcohol.
3. Withdrawal-presence of symptoms like
tremors, anxiety, loss of appetite and sleep, nausea vomiting.
4. Use despite harm
5. Neglect of alternate pleasurable
activities
6. Loss of control
A simpler
criteria is CAGE CRITERIA
C- Cut down,
felling that one should cut amount of alcohol
A-annoyance
on being called alcoholic
G-guilt
E- Eye
opener, need of alcohol on waking from sleep.
Treatment of alcohol addiction
On being diagnosed
with alcohol addiction by a psychiatrist following stages are underwent for
treatment.
1. Detoxification
2. Maintenance phase
Detoxification
of alcohol is done by benzodiazepines, with thiamine supplements. This lasts
for approximately 15-20 days
Maintenance phase-after
detoxification maintenance is on anti-craving agents like
Acamprosate
Topiramate
Baclofen
Naltrexone
During
maintenance phase a patient can also be prescribed disulfiram(ant abuse) but
great care should be taken as any contact with alcohol can lead to fatal
disulfiram alcohol reaction.
This lasts
for 6-8 months.
Psychological
support is also helpful in getting out of this ailment.
Psychotherapies
include-
A. Cue extinction
B. Relapse prevention
C. Motivation enhancement therapies
Self-help
groups like
Alcohol-anonymousare of great help in maintaining abstinence
For family
of dependent patients there are groups like
Al Anon, AlAteen
Alcohol
addiction is not a moral problem but a disease and should be handled as such.
Wishing you
a long and healthy life
Dr Hitesh
Sharma
MBBS MD (Psychiatry)
For asking a query or phone/video consultation with me visit- https://www.icliniq.com/hitesh
MBBS MD (Psychiatry)
For asking a query or phone/video consultation with me visit- https://www.icliniq.com/hitesh
