The Use of Medicine in Alcohol Treatment

Most of us know someone who has an alcohol problem. These are people who over indulge to the point of negative consequences to themselves or others. Negative consequences of excessive drinking might be marital or family conflicts, a negative job review, or a DUI.

Most likely, the problem drinker is not ready to address the problem. Long term use of alcohol can cause damage to the brain in the form of poor judgment, impulse control and memory. This in turn contributes to a high rate of denial and minimization – “I can stop any time I want to. I just don’t want to.”

Change often happens in stages. These stages include pre-contemplation (“I don’t have a problem”), contemplation (“maybe I have a problem”), preparation (“what are my options?”), action (taking action) and maintenance (staying on track).

When someone is preparing for change, it is helpful to provide a broad range of options. Most people are familiar with AA (Alcoholics Anonymous), detoxification and alcohol programs that address relapse prevention. Less familiar are the medications that are available. There are four medications for alcohol dependence: Antabuse, Campral, Naltrexone, and Vivitrol.

Antabuse discourages drinking by making the person physically sick when alcohol is consumed. Campral reduces the physical distress and emotional discomfort people usually experience when they stop drinking. It reduces sweating, anxiety and sleep disturbances that many experience in the early stages of alcohol abstinence. Naltrexone discourages drinking by decreasing the pleasurable effects of alcohol. This medication cannot be taken in conjunction with pain killers or other opiates. Vivitrol is an extended release form of Naltrexone. It is an injection taken once per month to decrease the pleasure of alcohol.

A variation on the use of Naltrexone is gaining popularity. The “Sinclair Method” treats alcoholism with a combination of Naltrexone and ongoing drinking, gradually extinguishing alcohol consumption. The drinker commits to taking one 50-mg tablet of Naltrexone one hour before drinking. Over the course of a year, the drinking will have greatly diminished. This treatment is widely used in Finland and I have seen good results of this method in my practice.

There are many forms of available treatment for people with drinking problems. If you have a problem, seek an evaluation by a qualified substance abuse professional.