Alcohol misuse is one of the common issues in the world, and millions are affected by the short-term and long-term consequences of excessive drinking. It leads to various physical, emotional, and social problems, including liver disease, heart disease, mental health disorders, and damaged relationships. However, it is treatable, and there are several approaches to help reduce or stop alcohol consumption. Alcohol use can be treated to as an individual need, which depends on the magnitude of their drinking and their individual goals, which may include moderation or abstinence from alcohol. Treatment aims at bettering the quality of life for this individual while avoiding these health risks posed by this risk of alcohol misuse.
Overview of Alcohol Misuse Treatment
Highly individualized treatment exists in alcohol misuse: a range of interventions, counseling, detoxification, medication, and therapy tailored to enable and support stopping alcohol or lowering their alcohol consumption altogether. This level of intervention in treatment can only be established for the amount and severity of the alcohol dependency to the client’s physical condition. There are four levels of treatment and options applied together or single-handedly toward the most advantageous outcome.
Brief Intervention
A brief intervention helps those who concern themselves with their intake but are yet to become alcoholic. This will be a short time counseling session most of the times that last within 5 to 10 minutes: aimed at providing increased awareness related to the threats of excessive consumption and assisting change in the concerned behavior.
Usually, a healthcare provider-who may be a physician or a nurse-delivers a brief intervention while conducting a routine examination or when attending to the alcohol-related injury or health condition. Brief intervention comprises of the following parts:
- Assessment: The doctor assesses the patient’s pattern of drinking and asks the number of units that are taken in, the frequency at which one consumes alcohol, and whether he suffers from adverse consequences of drinking.
- Information about the Risks: The provider explains the health and social risks associated with drinking too much alcohol, for example, health risks such as alcoholic liver disease, cardiovascular problems, and mental health disorders, and social risks such as problems with relationships or work.
- The healthcare provider gives advice on reducing alcohol consumption, according to assessment. This could include such helpful tips for cutting down on alcohol consumption as setting limits in terms of the number of drinks per day or week or choosing a non-alcoholic alternative when with friends.
- Support Resources: The offender is provided with information regarding support networks and encouraged to seek further aid, such as alcohol counseling services or self-help groups.
- Drinking Diary: A health care professional might recommend maintaining a “drinking diary,” recording alcohol consumed over time. It helps patients better understand and realize their own patterns of drinking and recognize situations in which they have problems with controlling alcohol consumption.
Moderation vs. Abstinence
Two most common treatment strategies for alcohol misuse are moderation and abstinence. Whichever approach would be appropriate will depend on an individual’s drinking habits, their general health, and goals.
Moderation
Moderation is reducing alcohol intake to within the limits of recommended levels, that is, not more than 14 units of alcohol per week. This is appropriate for individuals who consume excessively but do not show alcohol dependence and have no grave health problems connected with alcohol. An example would be an individual taking 20 to 30 units a week can be considered moderation as the initial step towards cure.
For most people who are not ready to quit drinking altogether, moderation is the more achievable goal. However, even with moderation, it is crucial to monitor progress and ensure that the individual is reducing their consumption in a safe and healthy way. For those choosing moderation, the following strategies may be recommended:
- Set limits: Set limits on how much alcohol should be consumed per week or per day.
- Alternate drinks: Change alcoholic beverages with non-alcoholic ones while at social functions.
- Avoid binge drinking: Learn how to recognize situations that may cause binge drinking.
Abstinence
Abstinence is a state of complete alcohol avoidance. This is usually advised to those who have developed alcohol dependence or to people who have severe alcohol-related health conditions, like liver disease, heart disease, or a history of alcohol-related accidents or injuries. Abstinence is also advised to pregnant women and individuals on medications that interact adversely with alcohol.
Abstinence is typically the best form of treatment for people who are alcohol-dependent or suffer from serious medical problems associated with alcohol use. This is an essential step for regaining health and preventing future damage to the liver, heart, and other organs. Sometimes, abstinence may be the best option for people who tried moderation but could not succeed in doing so.
Detoxification and Withdrawal
For those who are physically dependent on alcohol, detoxification or detox is an important first step in the treatment process. Detox helps manage withdrawal symptoms and removes alcohol from the body. Withdrawal symptoms can range from mild to severe, depending on the level of alcohol dependence.
Withdrawal Symptoms
These are symptoms that manifest themselves once the body, to which it has been accustomed due to frequent exposure to alcohol, does not get the drug. Symptoms range widely according to how much and how frequently someone drinks. The symptoms can be listed as follows:
- Anxiety
- Tremors or shaking
- Nausea or vomiting
- Insomnia
- Headaches
- Sweating
- Rapid heartbeat
- Seizures (severe)
Usually withdrawal symptoms start occurring within 6-24 hours after the individual’s last alcohol consumption and remain for a minimum of a week. The condition is most serious in the initial 48 hours. Proper supervision by a health care provider can be very beneficial, especially among those with very severe alcohol use disorders, for detoxification would be fatal and life-threatening.
Detoxification Process
Mild Cases: For those who drink moderate amounts of alcohol (less than 20 units per day), detox can usually be managed at home with support from healthcare professionals. A medical provider can check for withdrawal symptoms, counsel regarding hydration and nutrition, and administer comfort measures in the form of medication.
More serious alcohol dependence, or for those who have already had withdrawal symptoms, should undergo detoxification in a clinical environment, such as hospitals and special clinics.In some cases, medication may be prescribed to manage withdrawal symptoms and reduce the risk of complications.
Some medications such as chlordiazepoxide (a tranquilizer) can help in relieving anxiety, seizures, and other withdrawal symptoms. It should be remembered that chlordiazepoxide must not be combined with opiates like methadone or heroin, since dangerous interactions could occur.
Medication for Alcohol Dependency
Besides detoxification, several medications help a person in abstinence, reduce craving, and prevent relapse. The following are some of the medicines used in the treatment of alcohol dependency:
- Acamprosate: This drug is prescribed to individuals who have stopped drinking successfully, with the intention of preventing relapse. It helps balance the chemicals in the brain associated with alcohol cravings. Counseling and other behavioral therapies are usually used in combination with this medication.
- Disulfiram: The works of disulfiram entail the development of unpleasant reactions whenever alcohol is taken. These reactions may include nausea, vomiting, chest pain, and dizziness. It is used to deter people from drinking alcohol and is usually recommended for those committed to abstinence but may be at risk of relapse.
- Naltrexone: Naltrexone acts as an antagonist of alcohol by blocking the pleasurable effects of alcohol. This medication decreases the urge to drink and even helps prevent relapse. It is taken in conjunction with other therapies or counseling. However, it is contraindicated for opioid-dependent patients, such as those using morphine or heroin, as it blocks pain medication.
- Nalmefene: Nalmefene acts similarly to naltrexone, by reducing alcoholic urge. It is preferred when one has not yet developed severe withdrawal symptoms but still needs a reduction on alcohol consumption. Nalmefene is usually prescribed in combination with counseling or other support.
Therapy for Alcohol Dependency
Therapy is a very strong tool in making the individual realize the psychological and behavioral factors responsible for alcohol misuse. The practice of a number of therapies helps achieve long-term recovery and maintenance of abstinence.
- Cognitive Behavioral Therapy (CBT): CBT is a talking therapy helping the individual identify and change their negative thoughts and behaviors concerning alcohol misuse. It focuses on knowing the triggers that provoke drinking, such as stress, social situations, or negative emotions, and develops healthier ways of coping with those specific events.
- 12-Step Facilitation Therapy: This involves adherence to the AA framework in helping the patient carry out the process of AA 12-step. In this process, there is admission of alcohol dependency, making amends for previous behavior, and support of other members in the recovery process. It is offered in both group and individual settings.
- Self-Help Groups: Self-help groups such as Alcoholics Anonymous (AA) and SMART Recovery provide peer support along with a structured program to help the individual remain sober. AA is based on the 12-step program, whereas SMART Recovery is much more based on self-empowerment and cognitive behavioral principles.
- Family Therapy: Alcohol misuse is not only harming the individual but also his family and loved ones. Family therapy can educate family members about alcohol dependency, improve communication, and provide support to a person in recovery. Support for family members in coping with stress and emotional feelings of living with an alcohol abuser is also given.
- Support Services: Support to family and friends of a dependent person comes in the form of support services through organizations such as Al-Anon, where it helps to take care of emotions and develop skills to overcome challenges in recovery.
Monitoring Progress and Ongoing Support
Treatment of alcohol misuse is a process that takes on the lifelong process. Continuation with health care professionals who include counseling and drug management is necessary in order to recognize progress and ensure long-term success. Furthermore, self-help groups as well as therapy can offer the additional encouragement for individuals who are in recovery. Keeping a drinking diary or using mobile apps by tracking progress also helps individuals
