For a problem drinker, nothing melts the pain and frustration of life faster than alcohol. If you have a problem with alcohol, you might relate. In fact, this quick-fix mentality is often what causes so many problems in the life of a problem drinker. Rather than working through a problem slowly and diligently, you take a few drinks for an immediate sense of ease and comfort. For many, treatment of alcohol addiction involves therapeutic means as well as medication therapy.
Since alcoholism is so difficult to treat and cure, many doctors employ pharmaceuticals that help facilitate a long-term sobriety. Though some may find this methodology suspect and contrary to a working model of sobriety, medications have proved to be effective. They can help alleviate the symptoms of withdrawal, and other distractions, helping you focus on work that really will pay off over the long haul.
What medications are used?
When a doctor prescribes a medication for your alcohol use disorder, she may be seeking a few outcomes, depending on the specific scenario. Some medications can help ease you through withdrawal and detox, others treat your brain and help counterbalance whatever changes your drinking may have caused.
To treat your alcoholism, your doctor might use any one of the following:
- Disulfram
- Naltrexone
- Acamprosate
- Benzodiazepines
Disulfram
Disulfram is a pharmaceutical treatment for chronic alcoholics. This drug has been a key part of the alcoholism treatment kit for over 50 years. You may have heard it called by its trade name, Antabuse. This might be prescribed if you simply cannot control the obsession to drink or the compulsion to pick up a bottle. It is also prescribed as a part of a probation sentence that will assure the court that you are remaining drink-free.
The drug works by halting your body's ability to metabolize alcohol. If you are taking the medication and happen to have a drink, your skin may flush, your heart may palpate, or you may become nauseated. If you drink an excessive amount, you may incur even more severe effects. This is intended as a strong deterrent to drinking that may be helpful, particularly in the early stages of your recovery.
If, for instance, you are in an outpatient rehab program or attending 12-step meetings on your own, you might want a prescription for disulfram. Discuss this decision with treatment professionals and your sobriety network. Disulfram can be beneficial if you are feeling particularly tempted or if you are easily triggered by certain situations. That is, you will think twice before taking a drink if you know that it will immediately make you sick.
Naltrexone
Naltrexone is commonly known as an opiate antagonist. However, it is also used for those who suffer from an alcohol use disorder. Though this may be puzzling at first, consider that alcohol and opioids both focus on the same center in the brain, making them more similar than many people assume.
When you take naltrexone, you will find that your cravings for alcohol decrease. If you are still drinking, you should notice that the volume your drinking decreases. Not only that, but drinking will be less pleasurable, as your brain's alcohol (and opiate) receptors are blocked by the drug.
If you are in a treatment program, or attending 12-step meetings, the medication should perfectly compliment your desire to stop drinking. Given this information, naltrexone should not be seen as a quick fix for your alcoholic cravings, but rather an assist in helping you learn to quit and effectively manage what cravings you still have.
Acamprosate
Acamprosate is a drug your doctor may prescribe if alcohol was your primary, or sole, drug of choice. Like naltrexone, it will help to curb your desire to drink. If you drink while taking acamprosate, you will not incur any unpleasant effects, but you should discuss this with your doctor and the rest of your alcoholism support network.
This medication is a boon to alcoholics who maintain negative symptoms of their disorder over time. If you suffer insomnia, anxiety, or are subject to mood shifts that might trigger a relapse, this could be part of your sobriety program.
Acamprosate, also known as Campral, is not a quick-fix solution to your alcohol use disorder. However, if you have resorted to a prescription medication to help with your drinking, that should serve as a motivation to work with other treatments to solve your drinking problem. The medication will help heal the changes alcoholism has made to your brain and curb your cravings, but it will not do the core work you need to do. That is, you will need to work with other treatment modalities, such as the 12-steps or counseling, to address the underlying issues that caused the problem.
Campral has been proven effective in European clinical trials but has not been proven effective by American scientists. There were distinct differences in the study sample groups, so you might be more like the European subjects than their U.S. counterparts.
Benzodiazepines
Benzodiazepines are a class of anti-anxiety medications that include Xanax, Klonopin, and Valium. They are used for a variety of psychiatric reasons, including recovery from alcohol use disorder. In particular, benzos are used during the initial stages of detoxification. Without this class of sedative drugs, you might encounter seizures or other negative side effects that come when alcohol is removed from your system.
Since the goal of detoxification is to guide you safely through that potentially traumatic or even fatal ordeal, short-acting benzodiazepines may be prescribed. In particular, you may be prescribed Librium or Valium. Other medications such as oxazepam and lorazepam may be prescribed, but are less common. Your medical team will make the appropriate judgments based on your individual case.
Why add medication to a treatment program?
You might find it odd that medications, drugs, are used in the treatment of an addictive disorder. It may seem particularly odd if the drugs in question are known to cause traumatic, or deadly, interactions with alcohol. However, there is a method to the madness.
Pharmaceutical medications have been designed to help assist treatment professionals treat your alcoholic disorder. They are there to act as tools to facilitate existing methods and practices which have been in use for decades. Medications can be beneficial in treating your alcohol use disorder for a number of reasons:
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Curbs cravings
Medications such as naltrexone and acamprosate can help curb your craving for alcohol. Simply blunting those cravings in the early stages can mean the difference between relapse and long-term sobriety. If you are still actively drinking this may not seem as evident, but once you spend three or more days without drinking, the old cravings may arise. These can sneak up when you least expect and cause you to do things you might normally find absurd. Further, cravings can be so strong that they override your best intentions, they will coerce you into thinking that it will be okay if you take just one drink. Medications will muffle that irrational desire and give you time to calm down, call a supportive friend, or simply take a nap.
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Incentive to stay sober
If you are taking medications for your drinking, your drinking has become quite severe indeed. Your prescription in itself can thus serve as a daily reminder that you need to stay sober.
Medications such as Antabuse will provide physical incentives to avoid alcohol. If you are taking your medications regularly, you will not be able to take a drink without experiencing uncomfortable effects. Since Antabuse stops your body from metabolizing alcohol, you may even suffer dramatic medical repercussions if you drink too much.
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Psychological Support
Medications are surely not the end-all to treating alcoholism. In order to get the disorder under control, you will need many, many tools in your sobriety toolkit. You may need a supportive network of friends and family. You may need a wide network of sober friends in a 12-step or other sober community. You may even need a team of addiction professionals who have academic and real-world training in the treatment of alcoholics and addicts. Lastly, you might need a prescription to take every day. Simply having that printed bottle of pills may serve as an emblem of your dedication to sobriety, health, and living the best life possible.
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Deal with underlying emotions
Your feelings may be a huge part of what leads you to take a drink. Emotional responses to everyday occurrences at work, in traffic, or elsewhere may be triggers that lead to a relapse.
While you work with the underlying issues that started the drinking problem in the first place, medications can help you see your feelings in a more objective light.
Medications such as anti-depressants and even sleep aids might be able to help you manage stress and anxiety in a way that gets you past a craving, or through a particularly difficult time. In fact, sobriety itself can bring up many difficulties.
Once free of alcohol, you may finally face your family and problems that have arisen from your drinking. This is stressful. The same can be said when you face a trauma from childhood, or begin to repay financial obligations that you had once wished would evaporate in a bottle. Pharmaceuticals can help ease that process so that those old feelings and problems don't trigger your old go-to methods of self-medication and destruction.
How to acquire medications
If you need medications for your alcohol use disorder, or alcoholism, you can seek a prescription from your local physician. If your state licenses doctors in addiction medicine, one of those professionals may be particularly helpful in determining which medications will work best for you.
The fastest route to finding pharmaceutical relief may be through an inpatient or outpatient rehabilitation program. They will have a psychiatrist on staff who can evaluate your problem and help find you the proper medications.
If you are in need of a detoxification program, the medical team there can provide you with the medicine you need to successfully navigate those early days of sobriety. They may put you on an IV drip of benzodiazepines or other medications to help ease your stress and anxiety. After all, alcoholic detoxification is potentially fatal, so you should have pharmaceutical assists ready.
Does medication negate sobriety?
This is often a hot-button issue in 12-step communities. Some maintain that you can only be sober if you are 100% free of any mood-altering substance. Others are less restrictive. Ultimately, this is a question that you need to answer on your own. The answer will depend on the sort of medication you are using and the way in which you use it. Any substance can be overused and abused.
If you are using your medicine like you did alcohol, then perhaps you should discuss this with the prescribing physician. However, if the medication is still providing you with the needed, intended assist that it was prescribed to provide, then you are likely okay.
Consider, too, that there are many ways of looking at the word sobriety. Some view it simply in terms of substance abuse, or the lack of substance use. However, the Big Book of Alcoholics Anonymous says that "bottles were mere symbols" of a deeper problem (paraphrasing.) That is, sobriety is about dealing with the causes and conditions that led to such extreme drinking and/or drugging.
In this light, medications can be the tools that help you avoid extreme substance abuse so that you can think and feel clearly enough to solve real problems. There is no great reward to be had in merely living dry, using mere willpower to resist a drink. Once you use the tools at your disposal to solve those underlying problems you may find that you no longer even think of drinking, as the problems you thought it solved are long gone.
The road to sobriety is not uniform and your pathway is yours, and yours alone, to trod. Whether you need medications will be a question that only you can answer. Regardless of the answer, keep one key motivation in mind: long-term sobriety.
