Alcohol Treatment Tips

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How do I deal with the psychological aspects of the disease of alcoholism?

Suggestions For Medical Interactions

Sometimes it is recommended that those in early recovery from alcoholism seek psychological support. Many people drink to "self-medicate" from otherwise intolerable feelings, such as anxiety, depression, and even mania or hallucinations. These things may not go away once you get sober. In fact, they may become harsher.

While internists are an excellent resource for those of us struggling with strictly medical problems, and can be useful to you in retrieving your physical strength, it is recommended that you seek psychiatric support for any questions/concerns regarding your mental health. It is highly recommended that you do research on psychiatrists who specifically have experience in the area of alcoholism.

Alcoholism/Addiction are largely under-researched and misunderstood-even in the medical field. Thus, it is crucial that you examine your options prior to treatment so that you can receive the highest and most appropriate level of care. Expert opinions, such as from the renowned David Gastfriend, MD of Harvard Medical School, are a good place to start your research.

What Should From Early Rehabilitation from Alcoholism?

Alcohol Rehabilitation: What to Expect

The first part of rehabilitation must include medical and possibly psychological attention. Physical and mental examination will be required. It is suggested, as stated in the detox section, that you check into an inpatient drug/rehab facility to get that initial push towards recovery. Be prepared to answer questions about your medical history, past lifestyle, patterns, relationships and use. This is not to be invasive, but rather to get a full bio-psychosocial picture of you so that optimal treatment can be provided.
You cannot recover from alcoholism by simply reading a list of tips such as are offered here-although reading this is a good place to begin and to tap into more expansive resources.

What is emotional withdrawal and how can I cope?

Emotional Withdrawal From Alcoholism

Once you decide to stop drinking, emotional withdrawal can be quite severe. Alcohol has most likely become the your best friend. It is the one thing the alcoholic can always rely upon to take away his/her feelings. This "best friend," though, is the equivalent of a best friend that would sleep with your wife or husband, steal all your money and then murder you in the end. Even though this "best friend" was the furthest thing from that in reality, you will still grieve. Many experts believe that a person's emotional development is stunted at the time of use. If you have been drinking since you were a teenager, you will likely have a lot of energy and feelings with which to cope. To channel this energy - this combination of misery and euphoria you will experience in early sobriety - stay active and engage in activities that increase your self-esteem. Learn to run. Go for walks. Take up visual art. Join a cooking class (eating sugar is recommended, if you aren't diabetic). Take a different route to work. All of these things will replace your negative emotions with positive ones, as well as take up the time you would have formerly spent drinking.


What's the difference between substance abuse and substance dependence?

According to the American Psychiatric Association, substance abuse is the excessive use of a substance that continues despite negative consequences. For example, if you have too much to drink and get arrested for DUI, AND you continue to drink excessively, you're abusing alcohol. Substance dependence indicates that your body has become physically and psychologically addicted to a substance. You will experience both withdrawal symptoms and "tolerance," which means that it takes more and more of the substance to achieve the same effect. Using the substance virtually dominates your life, negatively effecting your home life and work. Both substance abuse and dependence can be treated.

What happens during alcohol detox? What is the best way to detox from alcohol?

Alcohol Detox

One of the characteristics of alcoholism is that the "alcoholic" will suffer withdrawal symptoms when he/she ceases use. There are physiological and psychological consequences. Here, we will focus on the physiology of the disease.

In late stage alcoholism a person may not be able to go more than an hour or so without his/her "fix." Some withdrawal symptoms may be shakes, nausea, anxiety, and even hallucinations According to Substance Abuse Counseling: Theory and Practice (third edition) by P. Stevens and R. Smith, " severe cases, seizures, delirium tremors, cardiovascular collapse, death."

Detox from alcoholism is the only form of substance abuse detox that can lead to death. Simply put, this is because alcohol can and does affect almost every organ of the body. The liver, which is the organ the detoxifies the body, is the most affected organ. In other words, this is very serious and you should never consider attempting detox alone. If you are ready to quit drinking, it is crucial that you check into a treatment facility with medical staff trained in this area.

How does one diagnose him/herself as an alcoholic? How do I know if I have a problem with alcohol? Where can I find out about the disease of alcoholism?

Alcohol Dependence And Abuse

The first important element of beginning treatment for any type of addiction, including alcoholism, is to arm yourself with the facts. One of the best places to begin with the book, "Diagnostic and Statistical Manual of Mental Disorders," 4th Edition (more affectionately known as the DSMIV). This book is the go-to manual for all professionals dealing with any mental disorder. In other words, this book lists all the facts and symptoms regarding every single mental illness in existence. Alcohol Intoxication, Alcohol Dependence and Alcohol Abuse are each listed and defined in this book.

A person who has trouble with their drinking or cannot stop drinking despite a strong desire and his/her best intended efforts can begin here. Notated symptoms, such as "a persistent desire or unsuccessful efforts to cut down or control drinking" ( symptom of Alcohol Dependence) can lead an informed decision about whether or not you need help with your drinking.

How do I begin to rehabilitate from alcoholism?

Alcohol Rehabilitation: Getting Started

Alcohol detox is only the preliminary phase of alcohol rehabilitation. Alcoholism is a disease that permeates more than just the life of the alcoholic; its effects manifest itself in the lives of family, friends, coworkers, and acquaintances; and rehabilitation from alcoholism is a life-long journey.So just like one would gather information about his/her disease if it were diabetes or asthma, the same is required to determine effective treatment/rehabilitation choices for recovery from alcoholism. A good place to begin is with the American Academy of Family Physicians website.

The highlighted article, titled Alcohol Related Problems: Recognition and Intervention, by Burge and Schneider, gives helpful information about the effects of alcohol on the body and mind and offers helpful question/answer techniques to determine the severity of one's alcohol dilemma. The difficulty of recognizing early-stage alcohol (an ideal time to receive intervention) problems is explored. Start here to determine which kind of early intervention will be most effective for you. It is also recommended that you ask a very close relative or friend to go through this information with you. This person will care enough about you to be honest with you about how they perceive the severity of your drinking problem.

What are the psychological affects of alcohol withdrawal?

Dealing With Psychological Affects of Alcohol

Alcohol is a disease that manifests itself both physically and psychologically. Here we will deal with the psychological components of the disease.

Simply put: Alcohol abuse messes up your thinking. Your emotions are displaced, distorted and deviant. When you are finally at the point where you want to stop drinking, you may feel helpless, hopeless, and devastated. You may be too afraid to kill yourself, but simultaneously too afraid to live without alcohol. The Big Book of Alcoholics Anonymous refers to this as "the jumping off point." You will feel irritable, anxious, exhausted, ashamed, fearful and maybe even hopeful, but all at the same time. You cannot experience this alone.

At this point, it is necessary to arm yourself with a network of support. Attend Alcoholics Anonymous (in major city's like Chicago there are 4,000 meetings a week). It is also recommended that a medical doctor, a therapist and a network of sober, supportive friends be used for assistance during this time. You are not the professional here, so seek help from others who understand you. Trying these new tools will help. You cannot think your way into a new way of acting, but you can act your way into a new way of thinking and feeling.

Am I ready to quit drinking?

Are You Ready For Recovery?

Rehabilitation from alcoholism is not possible unless the alcoholic is willing and ready to change. It may seem odd to you if you have lost your job, your family and everything you thought you loved and you still don't want to quit drinking. This is a normal part of the disease. Read that again: this is a normal part of the disease.

If you really want some help, there is hope for you. If you are reading this and wondering if you are the only person out there who feels this "crazy," then you are mistaken. There is a world of people who have felt as you do and who have made drastic life changes. And that change is available to everyone who wants it. But before you read on, ask yourself:

  • Have you had enough of alcohol?
  • Are you at a point where you cannot move forward?
  • Are you so sick of doing the same things and expecting different results, only to find yourself flat out on your back again?
  • Have you heard from enough people that your behavior makes them sad, or even want to keep you out of their lives?
If you answered "yes" to these questions, then you are ready to embark on the very difficult process, yet ultimately rewarding journey of true recovery/rehabilitation from alcoholism.

What are some of the emotional and social effects of alcoholism?

Emotional Effects of Alcohol Abuse

A well-known effect of alcohol consumption is the shedding of inhibitions. Drunk people often behave in ways that violate their own values and sense of safety, exposing themselves to risks and acting without awareness of their situation.

Alcohol also magnifies existing emotions. A depressed person who drinks becomes more depressed. An angry person who drinks becomes angrier, and may become violent. Alcoholics, like all addicts, rearrange their lives to protect their sources of supply, and do not hesitate to lie to loved ones or violate the law.

Drinking can put people in danger because they are too drunk to realize they are in an unsafe situation. Drinking can also imperil one's social relationships, expose the drinker to ridicule, and harm performance in work and school.


What is Campral?

Campral is a medication used to treat alcoholism. The drug reduces cravings for alcohol and preoccupation with drinking. It is the only medication of its kind currently available in 12 states in the US. The National Association of Alcohol and Drug Abuse Counselors is actively lobbying to have this medication available to alcoholics in recovery in every state. If your state doesn't yet have Campral, you can purchase it through a mail-order pharmacy with a doctor's prescription. Campral is NOT like Antabuse, which makes you physically ill if you drink while taking it; Campral works quietly on your brain neurotransmitters to help you stop thinking about drinking. It is an enormously valuable tool in relapse prevention.


Your Window of Recovery Opportunity

The chances of seeking help for alcoholism are optimal during your the moments of awareness. After a few hours of obsessing about the mistakes you made while drinking, your mind will quickly convince you to pick up a drink to satiate the shame. That is the last thing you really need at that moment. You will quickly forget the mental, legal and psychological trauma of your last "drunk" and resume negative repetitive behavior. So when you feel badly about your drinking, act fast.

It is suggested that the morning after your last episode, when you are overwhelmed with discomfort, that you call a local AA office and ask someone for help. This way, someone else's clearer thinking can get to you before your disease tells you to cover up the embarrassment with another self-destructive behavior. It is also suggested that you seek medical attention immediately if you have a history of frequent use. See detox section for the importance of this decision.


I've stopped drinking/using. How can I prevent relapse?

Learn to recognize your relapse "triggers." Stress, relationship problems, occupational problems, financial difficulties, physical illness - all these can trigger a relapse. Prepare IN ADVANCE how you will cope with these triggers without drinking/using. Don't wait until the problems are upon you; by then it's too late. Work with your addiction therapist to develop a real, workable relapse prevention plan of ways you can cope with life's many stressors, sober! Stay away from your old drinking buddies and bars. If you hang around a barber shop, sooner or later you're going to get a haircut! You may also need to be treated for depression; many addicts have a co-existing mental health disorder that can be a huge relapse trigger. Also consider taking Campral, a medication that reduces cravings and preoccupation with alcohol. If you feel you're about to relapse, call your AA, NA or RR sponsor and talk it through. Go to meetings and find help with fellow addicts. All these things work - if YOU work them.


How can I tell if I have a drinking problem?

The National Institute of Health recommends no more than two drinks per day for men, one drink per day for women. If you habitually drink more than this, it's time to assess your drinking habits. Do you drink to get drunk? Do you drink to cope with negative feelings and situations? Do you drink in the morning? Are you frequently hung-over? Have you ever been arrested for DUI or other offenses while drinking? All these are signs that you may have a serious drinking problem. Go to the Alcoholics Anonymous home page, and take the "AA Twenty Questions" assessment. Be honest! No one will see this but you. This assessment will answer many of your questions about alcoholism, and whether or not you have a drinking problem.


Now that I'm sober, will I ever be able to drink again?

Probably not. If you were physically and psychologically addicted to alcohol, you STILL have this medical disease; it's simply gone into remission. If you try to drink moderately, you will probably fail and end up just where you were before you stopped drinking. However, some addiction experts disagree with this viewpoint. Moderation Management is a recovery program for those who have abused alcohol, but were not addicted to it. Rational Recovery also has this viewpoint. The premise here is that after you've been sober for at least a year, you may wish to try moderate, controlled drinking. The long-term efficacy of these programs has not been determined. The choice is yours.

What are some of the physical effects of alcoholism?

Physical Effects of Alcohol Abuse

Many people are familiar with the immediate effects of alcohol consumption -- euphoria, slurred speech, exaggerated emotional states, dehydration, and slowed reaction time.

Over time, alcoholism leads the body to become more efficient at processing large amounts of alcohol, which leads to "tolerance" -- the necessity of consuming ever-increasing amounts to get the same high. This also increases nervous-system activity, leading the drinker to become irritable when not drinking.

In the long term, alcohol consumption can cause cell death and hardening of tissue in the liver (cirrhosis); reduction in brain mass; ulcers; blindness; high blood pressure, and lower sperm count in males.

Many alcoholics also do not get proper nutrition, and suffer various malnutrition-related ailments such as anemia. Also, alcoholics are more prone to falls and suffer greater rates of bruises and broken bones.

What medications are available to treat alcoholism?

Medication for Alcoholics?

There are three drugs approved to treat alcoholism. All are meant to work only after the patient has become alcohol-free.

-- Antabuse, approved in 1948, works by causing nausea and other unpleasant symptoms when the patient consumes alcohol. However, those who want to drink simply stop taking the drug or choose to ignore the symptoms, limiting its effectiveness.

-- Naltrexone (ReVia) is meant to help patients in recovery stay away from alcohol by blocking the "high" from alcohol consumption. Its effects are limited and it is only approved for use in conjunction with supportive therapy.

-- Campral, approved in 2004, may help reduce cravings.

Alcohol depresses the central nervous system. Depression and anxiety are related emotional conditions that are very common among alcoholics. Antidepressant and antianxiety drugs may help reduce these disorders, which can contribute to cravings.


Alcoholics Anonymous

By now most people are familiar with Alcoholics Anonymous and the 12-step model of recovery through self-help and peer support. When AA first began, though, its illness-based philosophy was a revelation to alcoholics who had up till then been told their drinking was a moral failure.

The 12 steps encourage the alcoholic to admit a problem, to seek spiritual help with that problem (including a "fearless and searching moral inventory" of themselves), making amends for past wrongs, and supporting one another in establishing and maintaining abstinence.

A key concept in AA is "one day at a time." Rather than plan a life of abstinence, which can seem overwhelming, alcoholics commit to abstaining just for today -- over and over. Because of this, alcoholics are not considered "cured," even after years of sobriety -- they refer to themselves as "in recovery."

One of the criticisms of AA is its religious component. While members are not required to belong to any particular religion, the 12 Steps refer to a "higher power" or "God as we understand Him" which can be off-putting to those who are atheist, agnostic, or belong to less conventional religious groups. Because of this, some groups have adapted the 12 Steps to meet different sets of needs. One of the most active of these is Rational Recovery, which lobbies against court-mandated AA participation.

The AA answer to these critics is that it is common for alcoholics to claim they are somehow different from other people ("terminally unique"), and that the patterns of disease and recovery are the same no matter what your beliefs.

What is the first step in getting help for alcoholism?

Getting Help for Alcoholism

Some alcoholics will decide on their own to get help for the disease. Others may be pushed to alcohol rehab by a health care provider, clergy member, spouse or partner, child, parent, or even the legal system.

In some instances, the people close to an alcoholic can stage what is called an "intervention," which exposes the alcoholic to the truth about the effects of his or her drinking. These are not always successful and should be performed in consultation with a responsible professional.

There are many resources available once the alcoholic has made the decision to get help, but no one else can make that decision on an ongoing basis. Fortunately, there are also resources to help the people close to an alcoholic set reasonable boundaries and get support for their own stressful situations.

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Barbara Gibson
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