Although the obvious treatment for alcoholism
-just don't drink the alcohol!- seems and in fact is quite simple in
theory, it is
by no means easy in practice for individuals with the medical illness of alcohol dependence.
The abnormal craving and mental obsession
alcoholics have for alcohol causes them to return to it again and again even
when their drinking has repeatedly caused terrible problems for themselves and
others. Even when they finally reach the stage at which they genuinely want to
stop drinking, many alcoholics find abstinence from alcohol difficult or
impossible to achieve or to maintain. They may stop for a while only to resume
drinking again later, usually with a recurrence of problems followed by another,
often unsuccessful attempt to stop and stay stopped drinking. Mark Twain said
that "It's easy to quit smoking - I've done it a hundred times." The
same applies to alcoholics who stop drinking. Many, in fact most will stop
drinking. But relatively few will be successful in staying stopped for a
significant period of time. And length of time without a drink is very important
for the alcoholic's recovery because time is required for his psychological and
physiological(biochemical) processes to begin to return to normal.
Anything that assists the alcoholic in
refraining from drinking alcohol, therefore, permits his natural bodily and
mental functions to reassert themselves after the deformations caused in them by
his prolonged drinking. The longer he goes without a drink the more normal his
system becomes. After a while most alcoholics no longer crave and never even
think about alcohol - unless they drink it and commence the pathological craving
and obsession all over again.
Antabuse(disulfiram) has been available for
many years as an adjunct to alcoholism treatment. This medication has no effect
on the desire to drink but causes severe sickness if alcohol is consumed while
one is taking it. Alcoholics who take Antabuse daily know that if they drink
they will get sick(vomiting), hence get a boost in the determination to stay
sober. The obvious problem and the reason that Antabuse is not more generally
effective than it has been is that alcoholics can simply stop taking the drug
and start drinking again after a certain period of time(but not right away -
Antabuse blocks drinking for quite a while after the last pill is taken). But
Antabuse can provide good protection against momentary and overwhelming urges to
drink in alcoholics who are otherwise very determined to stay sober.
Other medications such as Revia(naltrexone)
and acamprosate do not cause sickness if alcohol is consumed while they are
being taken but instead diminish the craving for alcohol and the pleasurable
effects from drinking it. Scientific studies show that alcoholics in early
recovery who are receiving the standard treatment for alcoholism(counseling,
group therapy, AA &etc.) and who are taking these agents along with it are
somewhat more successful in staying sober than those who are not. The effect,
while real, is not huge. But in a disorder as devastating and difficult to treat
as alcoholism, every advantage that can be gained for sobriety is worth using.
When other disorders besides
alcoholism(depression, bipolar disorder, anxiety, schizophrenia &etc.) are
present along with alcoholism, appropriate drug treatment of these conditions is
necessary lest they interfere with the recovery from alcoholism. However,
successful treatment of such associated("dual diagnosis") psychiatric
conditions does not itself directly affect the alcoholism, which is a separate
medical condition usually requiring separate medical treatment.
The links below will take you to
sites which provide more information about the specific drugs that have been
found useful thus far in the medical treatment of alcoholism. It is very likely
that new and better drugs will be available in the near future - and that a
truly effective treatment for alcoholism will become available that will make
its control possible on a much wider scale than ever before.
Meanwhile, alcoholics who get and stay sober
usually have to do it "the old fashioned way," namely (1) don't drink
the alcohol(one day at a time!), and (2) go to AA meetings. Currently available
drugs are seldom the total answer for the alcoholic in search of sobriety - but
in at least some cases, they can be of enormous assistance.
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