Alcohol dependence treatment phases and anti alcohol implant disulfiram
The goal of treatment is a complete renunciation of alcohol. Over time the organism is getting used to a state of sobriety and a life without alcohol becomes pleasant for a person, full of nice things and does not require titanic efforts to struggle with himself.
Alcohol dependence treatment consist of two phases:
- Inpatient stage - Formation of sobriety. This phase lasts for 7-14 days and includes: Diagnosis, alcohol detoxification, aversion therapy, treating alcohol craving, information therapy, campral protocol, disulfiram implantation, psychotherapy, outpatient alcohol dependence treatment.
- Outpatient stage - Maintaining sobriety, (our outpatient treatment when a patient receives a therapy according to a doctor's prescription at home, he regularly ( once in a month) comes to clinic at appointed time for check-ups and fixing procedures). This phase lasts 12 months.
First phase of alcohol dependence treatment in our clinic : Diagnostic
Tests for hepatitis B and C, HIV. Biochemical blood test, showing liver, kidneys and pancreas condition. Regular blood test. ECG. Physical examination. Evaluation of neurological status. Assessment of mental state. By using psychometric scales (Hamilton scale, Beck, MMPI), projective techniques we estimate level of craving for alcohol, the level of nervosis, depression, kind of sleep disorders, changes in personality, attention and memory dysfunctions . Motivation, criticism, level of volitional mechanisms are assessed.
Alcohol detoxification : second phase of alcohol inpatient treatment
Daily use of alcohol in the second stage of alcoholism leads to physical dependence. This is paradoxical condition when the organism adapts to survival under conditions of chronic poisoning. Individual feels relatively comfortable only under the influence of alcohol. As soon as the alcohol concentration decreases the crisis is evolving ( withdrawal syndrome). The main symptoms of alcohol withdrawal syndrome are anxiety, nervousness, irritability, insomnia, feeling of internal tremor, arms tremor, high blood pressure, rapid heartbeat, nausea, obsessive desire to consume alcohol. The duration and intensity of withdrawal crises depends on the duration of continuous use of alcohol, health status, amount of daily consumed alcohol. Emerging from a long drinking bouts can be very severe with the development of delirium or epileptic seizures. Detoxification is a complex of measures directed to facilitate the withdrawal, to eliminate alcohol and correct disorders caused by alcohol abuse. For the detoxification we use a range of medications to protect the brain (sedatives, anticonvulsants, vitamins, cerebroprotectors), to "unload" liver (hepatoprotectors), to stabilize the cardiovascular and respiratory systems. Infusions of polyionic, amino acid solutions are helpful in a complex treatment, A membrane plasmapheresis may be conducted in severe cases. Usually after 2-3 days of detoxification from alcohol the patient's condition significantly improves. Appetite, sleep, physical strength are restored. Nervousness is passing out, mood is stabilizing, memory is getting better. From that moment we start therapy that aims to form aversion to alcohol.
Aversion therapy : third phase
The meaning of the therapy is to form at subconscious level of the patient a negative attitude to alcohol , aversion to look at, to smell and taste of alcohol. Method is uncomplicated, but it very effectively eliminates the desire for alcohol. The point of the procedure is to restore the protective reflexes to alcohol intake. Alcohol rituals are simulated when the patient by his own hand pours his favorite alcoholic drink into a glass, brings it to his nose, smells it, takes a small sip into his mouth tasting alcohol for a few minutes. From the smell and taste he experiences an unbearable nausea. Vigorous vomiting appears during which the staff verbally establish a negative reaction into the mind of the patient. Sometimes few sessions of aversion therapy are enough to make a patient sick even by the simple mention of alcohol. Situation is quite common when a nurse hardly brings alcohol into a room for procedure, as patient begins to request to take "this stuff" away.
Treating alcohol craving with N.E.T. therapy : fourth phase
Net Therapy is a promising technique that reduces the craving for psychoactive substances, stabilizes mental processes, reduces the need for medication. Special apparatus stimulates ingenious endorphin system of the brain responsible for producing natural hormones of pleasure. The procedure is painless, not associated with an electric shock or convulsions. After the first 10-15 minutes the patient feels relaxed, peaceful , no muscle tension. the head and thoughts become clear. Patient feels calmness and confidence.
Information therapy: fifth phase
Usuall talks about the danger of alcohol and the belief that it is time to stop destroying himself and his family every addict had heard many times. Addicts become immune to these "lectures" very quickly . As soon as it comes to the problems, the patient's consciousness begins to build up protective barriers: " I have heard it, it is nonsense, it is irrelevant, etc". No more than 5 percent of information is absorbed by this way. Modern technologies allow during the session to use multiple channels of perception, to affect at subconscious level, providing information intake up to 50-60 percents . Actually, information therapy is a formation of new patterns of behavior, restoration of sober system of values and volitional mechanisms.
Pharmacological blockade by anti alcohol implant Disulfiram
Disulfiram, Antabuse, Esperal, Tetidis can cause an unpleasant reaction to alcohol. The man who took 500 mg of esperal in the morning and then drunk a few sips of beer during the day will feel the following symptoms: typical reaction appears in reddened face and neck, spots all over the body, nausea, feeling short of breath, heaviness in the head, dizziness, increased and then decreased blood pressure, fast and irregular heart beating. Use of alcohol becomes impossible. The problem with regular daily intake these pills occurs in situation when a patient due to desire for alcohol starts looking for a way to stop taking the pills-blockers. Therefore, a more reliable pharmacological isolation provide so-called implants - blockers of prolonged action. Implants, or as they are called in America pellets contain a large dose of disulfiram and auxiliary substances, ensuring its gradual resorption and maintaining a sufficient level of a blocker in the tissues. Implant is put under the skin. Implantation is performed under local anesthesia so it is painless. 2-2,5 cm incision and 2 stitches are enough. Implants, depending on the dose and the manufacturer are 2, 6 or 12 month of lasting. There is a depo-injection of disulfiram (liquid implant), which operates 28 days. We recommend to maintain blockade for 12 months. Upon expiration of the implant it is not necessary to remove it, since after a while it is completely dissolved. Therapy by implants provide excellent results, due to the fact that during the period of their validity use of alcohol is impossible.
Campral treatment for alcoholism is sixth phase
The drug, which reduces the psychological need for alcohol. Here's what Wikipedia says about him:
While the Food and Drug Administration (FDA) in the United States approved this drug in July 2004, it has been legal in Europe since 1989. After it approved the drug, the FDA released this statement:
"While its mechanism of action is not fully understood, Campral is thought to act on the brain pathways related to alcohol abuse. Campral was demonstrated to be safe and effective by multiple placebo-controlled clinical studies involving alcohol-dependent patients who had already been withdrawn from alcohol, (ie, detoxified). Campral proved superior to placebo in maintaining abstinence (keeping patients off alcohol consumption), as indicated by a greater percentage of acamprosate-treated subjects being assessed as continuously abstinent throughout treatment. Campral is not addicting and was generally well-tolerated in clinical trials. The most common adverse events reported for patients taking Campral included headache, diarrhea, flatulence, and nausea. "
We use Campral for about 5 years and have seen its effectiveness.
Psychotherapy one of the phases in alcohol addiction program
An integral component of any addiction treatment program . Our therapists, special educators possess both classical method (Minnesota model, 12-step program) and transpersonal techniques of Grof, Holotropic sessions, the symbol-drama technique . We regular conduct joint family psychotherapy sessions with relatives during their visits.
Together with a patient the counselor works out a plan of activity for the next month, discusses the factors which may trigger relapse, the mechanisms of protection against it.
Instructions and preparation for the outpatient phase
Before being discharged from the hospital a detailed conversation is carried out in which the patient and his family receive the necessary information about which medications should be taken after discharge, advices on how to behave in a particular situation, to what changes in the patient's condition attention must be paid, schedule for the following monthly check ups. Doctor answers all patient”s questions. After a patient receives discharge certificate he leaves the hospital and outpatient phase of treatment begins.
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