What Is Alcoholism?
Alcoholism or Alcohol Use Disorder (AUD) is a chronic medical condition characterized by the inability to stop alcohol use despite its adverse impacts on different aspects of one's life.
Alcoholism may isolate one from their family and society and can even affect their career. The rate of alcoholism is reported to be highest among people without homes.
The American Society of Addiction Medicine defines Alcoholism or Alcohol Use Disorder(AUD) as a chronic brain disorder. As alcoholism is a chronic condition, it has the potential for relapse. As per the National Institute on Drug Abuse, about 40 to 60 percent of people with alcoholism relapse after treatment. As alcoholism is a chronic condition, no permanent cure exists; it can only be managed with treatment.
The following signs and symptoms help distinguish an alcoholic from an alcohol user. If two or more of the following pattern of behavior are present for more than one year, then alcoholism is considered. These patterns of behavior include the following:
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Have an intense craving for alcohol.
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Have withdrawal symptoms when prolonged alcohol use is stopped.
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Alcohol consumption in large amounts for prolonged periods.
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Alcohol use restricts social, career-related, and recreational activities.
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Failure to cut down or stop alcohol.
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Having alcohol tolerance and needing more alcohol to gain a similar effect.
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Failure to meet familial, career, and societal responsibilities due to alcohol use.
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Continued drinking even in physically hazardous situations.
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Continued drinking even after having physical and psychological problems related to the same.
What Are Alcohol Withdrawal Symptoms?
Individuals who consume alcohol heavily may experience alcohol withdrawal symptoms within hours to days after discontinuing alcohol use. These symptoms include the following:
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Sweating.
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Nausea and vomiting.
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Insomnia (inability to sleep).
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Anxiety and agitation.
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Increased hand tremor.
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Seizures.
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Hallucination.
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Increased pulse rate.
What Are the Different Types of Alcohol Rehabilitation Programs?
As per National Institute on Drug Abuse, the different alcohol rehabilitation programs include the following:
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Detoxification and Medical Management: In most cases, alcohol rehabilitation starts with detoxification and medical management. Individuals admitted to inpatient detoxification receive staff monitoring, full-time care, and management of withdrawal symptoms. Medications are administered to prevent complications like seizures.
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Residential Treatment: This inpatient treatment addresses the behavioral and social problems linked with addiction. After managing withdrawal symptoms, the patient is treated on a residential or outpatient basis based on the treatment needs. Along with the therapy, the patient participates in peer support groups. After treatment, the patient is transferred to an outpatient or other aftercare program to reduce the risk of relapse.
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Outpatient Treatment: Outpatient treatment is done after inpatient care to reduce relapse risk or done by those who need more flexibility with the treatment as they have professional or educational goals to work along with.
What Are the Medications Prescribed During Alcohol Rehabilitation Programs?
Medications are usually used for treating withdrawal symptoms during the detoxification stage.
The common medications used include the following:
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Benzodiazepine treats seizures and other withdrawal symptoms.
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In patients who cannot tolerate Benzodiazepine in those cases Carbamazepine, Phenobarbital, and Gabapentin are used.
FDA (Food and Drug Administration) approved drugs for Medication Assisted Treatment (MAT) include the following:
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Acamprosate - Acamprosate reduces insomnia, mood swings, uneasiness, and restlessness.
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Disulfiram - Disulfiram is an alcohol deterrent that produces flushing, palpitation, and nausea if alcohol is consumed.
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Naltrexone - It is an injectable medication given once a month. It helps in decreasing cravings and reduces the rewarding effects of alcohol.
What Is the Duration of an Alcohol Rehabilitation Program?
The duration of the Alcohol Rehabilitation Program varies from person to person depending on needs and may last for a few days involving only detox or may last months.
The common ones are explained below:
1) Thirty-Day Rehabilitation Program: A thirty-day rehabilitation program lasts three to six weeks and is a short-term rehabilitation program. It involves medical management, Medication Assisted Treatment (MAT), and behavioral therapy. The behavioral therapy done following detoxification and medical management includes the following:
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Contingency Management - Contingency management involves participation in treatment sessions and reaching milestones for which small rewards are given for motivation.
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Cognitive Behavioral Therapy - Cognitive behavioral therapy helps in developing coping skills and helps to manage cravings.
2) Motivational-Enhancement Therapy - This therapy works by changing behavior. The counseling sessions conducted include the following:
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Family Therapy - Family therapy sessions are conducted for the individual and family members to help build healthier family relationships that aid recovery.
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Individual Counseling - Individual counseling involves one-to-one sessions with the individual where the person can express his issues.
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Group Sessions - Group counseling is conducted along with the peer group and provides additional feedback and reinforcement.
3) Sixty-Day Rehabilitation Program: A Sixty-Day Rehabilitation Program involves the following:
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Detoxification - The medical staff monitors the patient continuously during the detoxification process.
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Medications - Medications like Benzodiazepine, Acamprosate, Naltrexone, and Disulfiram are administered to reduce withdrawal symptoms.
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Therapy Sessions - Individual, group, and family therapy sessions are conducted.
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Aftercare Planning - Aftercare planning begins on the first day of treatment. It involves the individual, family, and staff planning the best ways.
4) Ninety-Day Rehabilitation Program: In a ninety-day rehabilitation program, one first undergoes detoxification and medical management to treat withdrawal symptoms. After physical alcohol dependence is overcome, the patient undergoes cognitive behavioral therapy, family therapy, individual therapy, motivational enhancement therapy, contingency management interventions, and finally, aftercare planning.
What Is Aftercare Planning?
Aftercare planning prepares one for post-rehabilitation life and begins mainly on the first rehabilitation day. Scheduled appointments help the individual to maintain sobriety post-rehabilitation. Aftercare planning provides support as one goes back to the daily routine.
The aftercare support programs include the following:
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Counseling session.
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Continued education on recovery.
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Medical, career, or psychiatric support services.
Conclusion
Alcoholism is a chronic brain disorder and not a weakness or moral issue. Like any chronic alcoholism does not have a permanent cure, and relapses can occur. Rehabilitation programs are suggested based on the patient's personalized needs. It includes combination therapy involving medications to reduce withdrawal symptoms and detoxification, followed by counseling sessions and behavioral therapy. Such programs involve a combined effort of the individual, their family, and health staff for faster recovery and aftercare planning.
