Naltrexone for Alcoholism Treatment

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Treating Alcoholism: Medication and Other Treatment Options

Alcohol is a legally controlled substance that lowers inhibitions with a range of additional side effects, including slurred speech and loss of coordination. Not all people who drink are alcoholics, but when they have no control over the quantity that they drink, alcohol use disorder (AUD) is likely.

In the United States, over 14 million adults struggle with alcohol addiction. However, treating AUD reduces the chances of severe outcomes like a fatal dose.

About Alcoholism

Alcohol is a commonly used psychoactive drug consumed in social environments. Ethyl alcohol, or ethanol, is the ingredient in alcoholic drinks that intoxicates a person. Alcohol comes in several consumable varieties, including beer, wine, and liquor.

Immediate and Long-term Effects

Alcohol slows down the brain because it’s a central nervous system depressant. This reaction leads to short-term effects like drowsiness, lowered inhibitions, distortion of senses and perception, coordination issues, problems with memory, slurred speech, and loss of consciousness.

Long-term alcohol misuse can lead to serious health risks. According to the World Health Organization, the drug is a causal factor in over 200 diseases and injury conditions. For example, chronic alcohol consumption can cause liver cirrhosis, addiction, unintentional injuries, and cancer. Other long-term side effects include:

• Liver disease
• Stomach ulcers
• Anxiety
• Depression
• Heart disease
• High blood pressure
• Dementia
• Digestive problems
• Brain and nerve damage
• Pancreatitis

Understanding Drinking Patterns

Because alcohol is so common, it’s challenging to differentiate between abuse and casual use; in 2019, almost 70% of American adults had drunk alcohol in the past year. Although no quantity of alcohol is risk-free, specific drinking patterns reduce the likelihood of developing AUD.

If someone of legal drinking age chooses to consume alcohol, it’s recommended to do so moderately; heavy drinking comes with greater risks. Moderate drinking is generally two standard drinks a day for men and one a day for women. Heavy drinking is defined as four drinks or more for men and three or more for women per day, or 15 drinks or more for men and eight or more for women.

Another unhealthy drinking pattern is binge drinking, which involves raising a person’s blood alcohol content (BAC) to greater than 0.08. Drinking at least four alcoholic beverages in two hours is considered binge drinking. However, this is a common pattern, especially for college parties, but it can lead to addiction or fatal outcomes.

Symptoms and Warning Signs of Alcoholism

Alcoholism, also known as alcohol addiction, is characterized by an inability to ignore cravings for alcohol despite any negative impacts. AUD occurs when long-term alcohol use leads to chemical changes in the brain that cause the organ to adapt its typical functions to compensate for intoxication; this interaction creates a dependency.

Signs of alcohol addiction include:

• Needing more alcoholic beverages to feel the same
• Unsuccessful attempt to stop drinking
• Drinking more than intended
• Need to drink impacts work, school, or other obligations
• Feeling urges to drink alcohol
• Spending more time drinking and recovering from alcohol
• Putting aside interests and activities that don’t involve alcohol
• Experiencing withdrawal when not drinking
• Continuing to consume alcohol despite any health consequences

Alcoholism is a progressive disorder, which means its risk for health problems worsens with prolonged use. That means treating AUD is best done as early as possible.

The first step of treatment is detoxing the body, leading to extreme discomfort during withdrawal. Withdrawal symptoms include insomnia, nausea, vomiting, headache, and sweating; these symptoms subside about 48 hours after the last drink. About 5% of people experience delirium tremens, a severe symptom characterized by delusions and hallucinations. Detoxing under medical supervision makes the process significantly safer.

Following detox, treatment should include rehabilitation; these programs treat addiction and its root causes. Participating in aftercare programs also reduces the likelihood of relapse.

Dangers of Chronic Alcohol Use

Drinking too much alcohol impacts people in a variety of ways. Some of them include the following.

Liver Damage

Your liver’s job is to flush toxins like alcohol out of the body, but it might struggle to keep up during a binge drinking session. Alcohol can also kill liver cells, leading to scarring known as cirrhosis. Finally, chronic alcohol use could also lead to fatty liver disease, a symptom that your liver isn’t working as expected.

Heart Disease

Alcohol increases the danger of developing blood clots and high cholesterol and fat levels. In addition, heavy drinkers’ hearts may struggle more to pump blood throughout the body, increasing the risk of dying from heart disease.

Brain and Nervous System Issues

Alcohol impacts communication pathways in the brain, making it harder to remember things, speak clearly, move the body, and make decisions. Heavy drinking could also exacerbate mental health issues like anxiety, depression, and dementia. Finally, painful nerve damage may persist even after treatment.

Anemia

When the body can’t make enough healthy red blood cells to carry oxygen, it can develop ulcers, inflammation, and additional health problems. Drinking too much may also lead someone to skip more meals, cutting off an essential source of iron and other nutrients.

Cancer

Finally, there is a known link between heavy drinking and various cancers. Alcohol can damage the esophagus, throat, and mouth cells, leading to intestinal, breast, or liver cancer.

Alcohol Withdrawal and Detox

Binge drinkers and alcoholics experience a collection of symptoms known as alcohol withdrawal. Depending on how heavy and frequently a person drinks, the symptoms they experience may be mild, but withdrawal can also be life-threatening.

When a person with alcohol dependence suddenly stops drinking, the absence of the drug shocks the central nervous system. People who struggle with addiction turn to alcohol compulsively to avoid withdrawal, even if they know the drink is harming their relationships and health. Withdrawal is a major obstacle to seeking treatment.

Symptoms of Alcohol Withdrawal

It’s challenging to predict how a person will experience alcohol withdrawal, but the most common symptoms include:

• Headaches
• Confusion
• Anxiety
• Heart palpitations
• Fatigue
• Insomnia
• Nausea and vomiting
• Shaking and tremors
• Heightened blood pressure
• Irritability
• Sweating
• Delirium tremens

Delirium Tremens

Delirium tremens is a potentially fatal condition that characterizes extreme alcohol withdrawal with possible seizures. It occurs in about one in every 20 people undergoing alcohol withdrawal; it’s more likely to develop in people who have experienced withdrawal before and currently have a severe addiction.

Symptoms usually begin in the first three days following the last alcoholic beverage. It’s essential to seek help immediately if you or a loved one experiences the following classic delirium tremens symptoms:

• Hallucinations
• Emotional distress
• Fever
• Fatigue
• Hypersensitivity to light, touch, and sound
• Intense confusion
• Intense agitation
• Seizures

Alcohol Detox

The best way to overcome alcoholism is to quit using the substance. Alcohol detox requires someone to deliberately abstain from drinking so that their body will adjust to functioning soberly. This process can be painful and dangerous because of its full range of withdrawal symptoms that can lead someone to relapse; however, medically supervised detox allows them to achieve this goal safely.

Medications Use to Treat Alcoholism

Originally used to treat opioid addictions, naltrexone is an antagonist for recovering addicts. Those who take this drug no longer experience the same pleasurable side effects, making it a valuable medication to reduce motivation to use drugs or alcohol. This effect is also true for alcoholics.

Although the mechanism is not fully understood, the brain interacts with alcohol much as it does with opioids. In other words, the medication suppresses the pleasurable side effects and euphoria of consuming alcoholic beverages; alcoholics do not experience the same “reward” for drinking once they’ve started taking the antagonist, making them less likely to keep drinking.

Although the medication has a long history of success in treating alcoholics, it doesn’t work as effectively when taken alone; the antagonist doesn’t impact alcohol cravings or reduce the symptoms of withdrawal, making it more effective in concert with other treatment, including therapy, counseling, and a 12-step program.

Proper Use

People should only use this prescription medication under medical supervision. Although it isn’t known to interact with alcohol adversely, it should only be prescribed after someone completes the detox process and stops drinking alcohol entirely. Additionally, the drug comes with specific side effects that require the doctor to ensure the person isn’t pregnant or suffering from liver failure.

Sometimes, a doctor prescribes the antagonist for a short-term period, especially for clients in an inpatient rehab setting. However, long-term use appears to be the most effective for preventing relapse and keeping alcoholics in recovery; the medication is comparatively safe, and treatment could be indefinite. Finally, because this drug can interact with some opioids, it is recommended to refrain from using any illegal opioids and to inform the prescribing physician of all other medications someone is taking.

There are a number of benefits to using this medication to treat AUD:
• Fewer side effects when compared to other treatments
• Less severe side effects
• Reduces drinking motivation, especially among alcoholics who have relapsed
• Eliminates pleasurable drinking effects
• Improves the outcome of other treatment methods, such as counseling and therapy
• Therapeutic benefits generally outweigh side effects

Side Effects of Use

This medication has a long history of use, and there are plenty of studies focused on its side effects. One reason it has remained popular is because of its safety. However, there are some potentially severe side effects. Common side effects include:

• Nausea and vomiting
• Anxiety and nervousness
• Insomnia
• Diarrhea
• Aches
• Abdominal pain
• Headaches
• Dizziness
• Rash
• Chills
• Constipation
• Tiredness
• Tinnitus
• Change in average energy

Treatment Options and Rehab

Overcoming an addiction to alcohol begins with finding a qualified treatment center experienced in addressing co-occurring and underlying disorders. Because of how prevalent alcohol is in modern culture, a recovering alcoholic is often bombarded with triggers every day. As a result, treatment centers need to be equipped to help clients find healthier coping methods to manage cravings and triggers effectively.

The First Step of Recovery

The first part of recovery is getting the alcohol out of a person’s body. Unfortunately, people who struggle with severe alcohol addiction are liable to experience more intense withdrawal symptoms. Because of this, it is usually necessary for someone addicted to alcohol to undergo supervised alcohol detox to avoid potentially harmful or fatal complications, such as seizures or hallucinations.

Medications for Alcohol Treatment

One significant benefit of inpatient rehab treatment is access to medical experts who supervise and manage all physical aspects of alcoholism. In addition, using prescription drugs in concert with other treatment methods can boost a person’s recovery success rate.

Additionally, some medications can help relieve uncomfortable withdrawal symptoms to prevent relapse. Other drugs help create an adverse reaction to alcohol that reduces a person’s desire to drink more.

Inpatient Rehab for Alcoholism Treatment

Inpatient rehab allows clients to receive personalized round-the-clock care and individualized support from medical professionals. Inpatient treatment is ideal for anyone who must focus exclusively on recovery without worrying about distractions or stress from social, school, or work obligations. In addition, this environment allows clients to immerse themselves thoroughly in the recovery process, making it an ideal choice for someone who has been unsuccessful with other treatment methods. Inpatient treatment can last as little as 30 days or six months or longer; exact recovery times depend on an individual’s circumstances and needs.

Ongoing Recovery

After rehab, the best thing a recovering alcoholic can do to stay sober is to seek support for ongoing recovery and aftercare. Whether a person finds support in their networks or the company of other recovering peers, it is imperative to connect with other people to share stories and concerns.

External support groups include Alcoholics Anonymous, which popularized the 12-step process. The 12-step program emphasizes submitting to a “higher power” for help; while many interpret this higher power as religion, others may find a “higher power” from within.

Next Steps

Millions of Americans struggle with an addiction to alcohol, and hundreds of thousands seek treatment every day to overcome it. Many people have found success, and there are many options for recovery. If you or a loved one is ready to abstain from alcohol and take control of the addiction, help is available. Call Addiction Experts today to learn more about your options.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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