The general utility of this drug has not been established and many patients are not adherent to therapy. Adherence to therapy usually requires adequate social support, such as observation of drinking. For these reasons, the use of disulfiram is now limited. Disulfiram is most effective when administered under close supervision to highly motivated patients.
Naltrexone, an opiate antagonist, reduces the relapse rate and number of days of alcohol intake in most patients who take it correctly. Naltrexone is typically given at a dosage of 50 mg orally once / day, although there is evidence that higher doses (eg, 100 mg once / day) may be more effective in some patients.
Even with counseling, adherence rates with oral naltrexone are modest
- A long-acting depot form is also available: 380 mg IM once / mo. Naltrexone is contraindicated in patients with acute hepatitis or liver failure and in those who are opiate addicted.
- Clonidine, the oldest alpha-2-agonist, administered orally or transdermally, has been shown to be effective in reducing alcohol withdrawal symptoms, particularly hypertension and tachycardia, in patients with mild to moderate withdrawal.
- However, there is evidence that clonidine is effective as monotherapy for preventing alcohol withdrawal seizures or alcohol withdrawal delirium.
Acamprosate, a synthetic analogue of gamma-aminobutyric acid, is administered at a dosage of 2 g orally once / day. Acamprosate may decrease the frequency of relapse and the number of days of alcohol use in patients who relapse.
The ability of nalmefene, an opioid antagonist, and topiramate to reduce craving for alcohol is being investigated.
Al-Anon Family Groups
American Psychiatric Association’s Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder
LifeRing Secular Recovery
National Institutes for Alcohol Abuse and RecoveryFindtreatment.gov: Listing of licensed US providers of treatment for substance use disordersAlcoholAlcohol addiction is characterized by compulsive drinking behavior and addiction and tolerance.
Definition of alcoholism
Alcoholism is a chronic disease characterized by behavioral, physical and mental alterations caused by the compulsive consumption of large quantities of alcohol.
Alcohol Alcohol dependence, causes and risk factors and possible relapses
Alcoholic addiction, or alcoholism, is characterized by a behavior of compulsive seeking of alcoholic beverages and by addiction and tolerance (to achieve a certain desired effect the individual is forced to drink ever greater quantities of alcoholic beverages).
As with any substance addiction, even in alcoholism the abrupt cessation of alcohol consumption causes withdrawal syndrome, characterized by tachycardia, tremors, nausea and vomiting, agitation, hallucinations, convulsions. The effects of alcoholism heavily interfere with a person’s health and with his or her working, relational and social life.
Advertising message Alcoholism is defined by the simultaneous presence of:
1. Loss of control of alcohol consumption: evidenced by the “first drink phenomenon”, by ineffective attempts to control, by the continuation of compulsive behavior despite the serious consequences associated with such consumption.
2. modification of the consumption pattern with the appearance of a compulsive desire to drink alcohol even in the absence of intoxication in progress (craving).
3. addiction: inability to give up alcohol and consequent effort to get it, due to the irresistible desire linked to the pleasure of the intake (psychic dependence), with a tendency to increase the dose to maintain the same effect (tolerance) and to fear of the onset of organic symptoms of deprivation or withdrawal (physical dependence).
4. lifestyle change characterized by a tendency towards isolation, from deterioration to the loss of usual social relationships.
5. family problems, or in any case of the personal social network, which can lead to the disintegration of the family fabric and the appearance of frank manifestations of psychic, emotional and relational suffering in the partner and in the other cohabitants.