Although individual and group therapy can be useful in drinking cessation, those who only receive this type of treatment have a higher percentage of relapse than those who combine it with other options. One type of treatment that has been shown to increase the probability of maintaining abstinence is prescription medication.
Alcohol plays a major role in this society. It is consumed with meals, used to observe special occasions, served on religious occasions, and provided for social facilitation. While most can drink without developing a problem, it is estimated that approximately 4% of the world’s population struggles with dependence. Understanding the effects of alcohol on the brain can help in recognizing the need for treatment.
The Brain’s Reward System Plays a Role in Alcohol Dependence
This part of the brain is responsible for rewarding behaviors, such as eating and sex, that are crucial to human survival. One reason that some drugs, such as alcohol, can be abused is because of their ability to activate this process. The reward system functions by releasing dopamine, which saturates the brain and results in a pleasurable sensation. When this system becomes hyperactive, as occurs with excessive alcohol consumption, it can result in a euphoric sensation.
Some effects of dependence, such as cravings, result from the way in which alcohol activates this reward system. Excessive drinking can induce dopamine levels that are higher and longer-lasting than the brain’s own intrinsic rewards. When someone stops drinking, these dopamine levels fall back down to normal. Over time, however, these normal levels become inadequate at inducing pleasure and cravings occur.
Alcohol Treatment and the Use of Prescription Drugs
Most forms of treatment for alcohol dependence focus on helping the individual to stop drinking and then maintain abstinence. Although many find supportive group or individual therapy to be sufficient, some need more help. They turn to prescription drugs to stop drinking alcohol. Several drugs have been approved for this purpose and more are being discovered to have side effects that can be helpful in alcohol cessation. Some cause the person to become ill if they consume alcohol while others help reduce the cravings of dependence. Listed below are several drugs that are currently being used to treat alcohol dependence.
Antabuse (generic Disulfiram)
The client will need to stop drinking before starting this medication. It works by inhibiting the metabolism of acetaldehyde, which is the primary byproducts of alcohol digestion. Because the body is unable to remove this toxic chemical, the result of drinking is nausea, flushing, headache and vomiting. This is generally taken, in pill form, at a higher dose for the first two weeks followed by a much smaller dose for the remainder of the time it’s used. Unfortunately, because of the unpleasant side effects, supervised administration is often required because people tend to just stop taking it.
Campral (generic Acamprosate)
This prescription can only be taken after the client has stopped drinking. It decreases the desire for alcohol by, essentially, keeping neural receptors from causing the tolerant person to crave alcohol when they abstain from drinking. The drug is administered in pill form and is usually taken three times a day. Although it has not been very effective in heavy drinkers, this prescription can make it less likely that someone will return to drinking, once they have stopped.
Vivitrol/Revia (generic: Naltrexone)
This medication can be started while the client is still drinking. There’s no need to detox first. It suppresses alcohol cravings by blocking the brain receptors that are responsible for the reward response of alcohol. This is usually taken by monthly injections or twice a day tablets. This prescription is contraindicated in those who are taking an opioid medication. It is most effective in preventing heavy drinking, but does not tend to be effective at eliminating it altogether.
Topamax (generic: Topiramate)
Although originally used to help with seizures, migraines and appetite suppression, this drug is now being used for alcohol dependence, and the client doesn’t need to stop drinking before starting to take it. The way that it works is to alter brain chemistry, so the person loses the reward, or good feeling, experienced when drinking. The daily dose is started low, then gradually increased, over several weeks, to the optimal dose. A gradual decrease will also be required when stopping. Unlike some prescriptions, this one does seem to be effective in decreasing the number of days spent drinking heavily.
Lioresal (generic: Baclofen)
This drug has been used to treat multiple sclerosis for decades but has only recently shown promise in helping to treat alcohol dependence. Like some others, this drug works by reducing activation of the brain’s reward pathway due to alcohol consumption. It is taken, in pill form, three times a day. Although not yet approved by the FDA, it is showing promise by increasing the client’s ability to maintain abstinence.
What to Take Away from All This
There are many ways to help stop alcohol addiction and prescription drugs are one of them. But like anything else out there, they should not the only means of quitting. Just prescription drugs a lone will not help. Your surroundings must change along with your will. Rehab is another great resource that will help and is recommended. Physicians in rehabs will also normally prescribe the medications and be able to monitor your progress. These combined therapies can assist with defeating even the most stubborn alcohol dependence.