According to US government statistics, nearly 8 million Americans over the age of 18 have alcohol dependence. Alcohol dependence means that there has been a change in the body’s physiology requiring more alcohol to produce the same effect (tolerance) at the same time showing signs of alcohol withdrawal. Simply put, the body and the brain are addicted to alcohol.
Once a person has alcohol addiction, many things can happen over time: liver failure, bleeding disorders, enlargement of the heart, seizures, even brain damage called dementia. Getting alcoholism under control is the first step before any of these medical conditions occur. Most people can successfully cut down drinking and maintain a healthy and sober lifestyle however many cannot and require medical interventions before it’s too late.
Signs of alcohol withdrawal can include: hand tremors, high blood pressure, high heart rate and palpitation, sweating, insomnia, in- creased depression and anxiety, confusion, and if left untreated can lead to seizures or delirious tremens (DT’s).
Detoxification is oftentimes required to prevent seizures or delirious tremens (DT’s), both associated with increased risk of death. The standard of care for alcohol detoxification utilizes medical assisted treatment (MAT) with a group of medications called benzodiazepines. These are scheduled medications commonly used for anxiety, insomnia, and muscle spasms, which also carry their own risk of dependence but are extremely helpful as a short term treatment to prevent medical instability during alcohol withdrawals and the DT’s.
Many physicians are comfortable with prescribing a short term supply of benzodiazepines to help get off alcohol but your doctor instead may refer you to a trained Addictionologist, an MD or DO, that is specifically trained in the field of Addiction Medicine, to supervise and monitor for any complications that may arise during detox.
The Addiction Specialist will evaluate you medically and psychiatrically to determine which course of treatment will be best. Sometimes close monitoring at home of the blood pressure and heart rate is recommended but only after a comprehensive medical exam and work-up. A short course of medications as an outpatient is ideal in most cases however at times the Addictionist may recommend a higher level of care like the ICU because of severe medical complications or presence of DT’s.
After successfully getting stabilized after detox there should be a detailed treatment plan in place to maintain sobriety and reduce the risk of relapse. Detox is the first step in getting healthy but not considered treatment.
DO: Incorporate individual therapy and support groups.
Along with medication that will help with detox, cravings, and possible treatment for mood disorders, make sure that you have access to professional counselor and/or self-help groups to help you with personalized internal issues and create a solid treatment plan for your recovery.
DO: treat other medical or psychiatric conditions.
The professional or program responsible for treatment is also responsible for referring the patient to additional services that may be required as a supplement to addiction treatment. This could include medications to reduce cravings or block the effect of the drug, for example. Mood disorders also are highly associated with substance abuse disorders and should be identified and treated appropriately.
DO: stay committed to your recovery
There is no cure for any type of addiction. Addictions are chronic and lifelong conditions. Detox alone is not treatment. Understanding the forces that promote addictive behaviors are important. This may mean understanding underlying mood disorders that are oftentimes lifelong conditions. Being engaged with your treating MD, your therapist, being pro-active with communicating with your family and helping them understand what addiction is, are all essential maintain- ing your sobriety.
DON’T: rely solely on groups
Self-help groups are a valuable community resource for many people and their families. Although helpful at every stage of treatment and as a long-term social and spiritual aid to recovery, they should not be substituted for professional ad- diction treatment. Your treatment program should develop cooperative relation- ships with the self-help groups, since they work in compliment to professionally guided treatment.
DON’T: rule out anti-craving medications
Breakthroughs in the field of addiction medicine have made it possible for you to reduce cravings for certain addictions like alcoholism or addiction to heroin or other opiate based pain pills. FDA approved medications like (Vivitrol) naltrexone and acamprosate, can help keep you sober for longer.
DON’T: get over confident
Detox is not considered treatment, nor is graduating from a treatment program after 30 days. Addiction is a lifelong brain condition that has to be addressed chronically. Maintenance of disease remission is a life-long process and should be followed even after getting treatment, just like with other chronic relapsing illnesses such as diabetes and hypertension.
DON’T: think you can do this alone
Involving your family, spouse, and sometimes close friends are essential for healing for the whole family system. Addicts are not the only ones hurt during their addiction. Family, spouses, friends, are equally or many times, more effected by chaotic and irrational behaviors associated with addiction. Make sure that your addiction treatment plan includes and invites others to participate in therapy and educational classes about addiction.
Summary: Alcohol addiction treatment programs should be individualized and tailored to give clients choices, resources, and support to take responsibility for addressing their medical and psychosocial needs. Detox is essential especially when signs of withdrawal are present which can be life threatening.
You can get help for your alcohol addiction even if you have a busy life through outpatient treatment programs. However, keep in mind you should be supervised by appropriately trained professionals. The field of addiction medicine has developed new exciting and effective strategies that can treat your addiction at a bio- logical level. Monthly injections to reduce cravings, for example, can help you fight your addiction and make it easier on you during this stressful time. Also, counseling should always complement professional addiction treatment and can involve the whole family unit.
INSynergy offers the best Drug and Alcohol Treatment Program in St. Louis, MO.
We use an integrated approach with a system of medical professionals, psychiatrists, psychologists, therapists, and advocates to treat the whole person, not only the addiction.
Many times co-occurring conditions are overlooked such as depression, bipolar depression, anxiety, ADHD, and other psychological issues.
INSynergy requires that these Co-Occurring conditions are identified and effectively treated. Treating the whole person decreases risk of relapse.
By Arturo C. Taca, Jr., MD
Diplomate-American Board of Addiction Medicine
Diplomate-American Board of Psychiatry and Neurology
Medical Director- INSynergy
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