Treatment methods for alcoholism. Effective treatment for alcoholism. The most effective remedy for alcoholism: Rehab

Alcoholism is a disease that affects not only the somatics of a person, but also his psychological and social sphere. Alcohol dependence in most cases requires integrated approach. The goal of therapy should be to heal not only the biological, but also the psychological structures of the body of the addict, as well as his social adaptation. The AlcoMed clinic offers various modern methods alcoholism treatment. Experienced Doctors at any time of the day or night will provide the necessary assistance.

If you delay the treatment of binge - the situation will worsen significantly!

• 1 Anxiety, insomnia, unhappiness
• 2 Palpitations, high or low blood pressure
• 3 Strong desire to drink alcohol
• 4 Nausea, vomiting, intense thirst
• 5 Headache, dizziness
• 6 Tremor - small hand trembling

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Medical methods for the treatment of alcoholism

With drug treatment, coding is carried out with the help of special preparations. A drug is introduced into the human body, which not only significantly reduces the craving for alcohol, but also forms a toxic compound in case of alcohol consumption, thereby causing the patient to fear for his state of health in case of a breakdown. Drug treatment can be carried out with the help of injections or suturing the drug.

Sewing

The method is as follows: muscle tissues implanted (sutured) the right drug, which will constantly enter the bloodstream and block the production of enzymes required for the processing of ethanol. The drug is sewn in after the consent of the patient and abstinence from alcohol for a certain amount of time (3-7 days).

injections

The drug is given by injection. Before the procedure, the patient needs to completely refrain from drinking alcohol for a certain amount of time (3-7 days). Depending on the individual characteristics the duration of action of the drug may vary. The average period for which the procedure is enough is 1 year.

Medical methods used in the Alcomed clinic

"Aquilong"

It is one of the most popular methods of getting rid of alcohol addiction today. Aquilong method low toxicity, the effect of therapy is most pronounced in the first weeks after the procedure. This type of coding suppresses cravings for alcoholic beverages to the maximum extent. It has an effect at any stage of alcoholism. The coding period is one year. If necessary, the doctor may recommend it for three years.

"Sewing in Esperal"

If a person suffering from alcoholism is against the intravenous administration of any kind of encodings, AlcoMed can offer alternative way treatment - "Sewing in Esperal". After the onset of local anesthesia, the narcologist sews a low-toxic medicine under the skin. Most often in the area of ​​​​the scapula or buttocks, since it is very difficult to extract the medicine from these areas in case of a breakdown. In the fight against alcoholism, the drug shows excellent results. The drug is slowly absorbed into the blood and maintains the required concentration in it. active substance. This ensures the exclusion of premature excretion of the drug. After the procedure, the patient may experience inflammation in the sutured area. In the future, this can lead to fouling of the administered drug. connective tissue and impaired absorption of the drug into the blood. The recommended coding period is one year, but the use of the drug can be extended up to five years.

"Veritrol"

Another modern and enough effective method coding for alcoholism is "Veritrol". Doctors recommend it in cases where previous coding experiments have had little or no success. In the course of therapy, drugs are administered in two doses, the interval between them is at least half an hour. According to individual indications, a specialist can leave medicines for the patient's relatives for a full course of treatment. The therapy helps to reduce the craving for alcohol as much as possible and increase the effectiveness of the encoding. Medications are not addictive and can be combined with others similar means. The coding period is recommended for one year, and by decision of the doctor it can be extended up to 3-5 years.

"Nanoxol"

The modern technique "Nanoxol" is an exclusive method of coding from alcohol addiction. It is developed using the latest biotechnology. The injected drugs act at the cellular level, during which they block the brain receptors responsible for the occurrence of cravings for alcohol. In the event of a breakdown, a person experiences serious poisoning, tachycardia, convulsive syndrome, as well as a sharp increase in blood pressure (blood pressure). This method is recommended for patients in whom previous coding attempts have been unsuccessful. The procedure is carried out in two stages: 2 drugs are administered at least half an hour apart. The recommended coding period is one year, according to the doctor's indications - up to five years.

Psychotherapeutic methods used in the AlkoMed clinic

At present, the problem of alcoholism in Russian Federation and in the world is very acute: there is an increase in patients with the most severe manifestations, the course of alcoholism is often complicated by severe somatic diseases, adolescent alcoholism is progressing, there is no preventive anti-alcohol work with the population, intrusive alcohol advertising is progressing, the existing drug treatment system is being reduced, there are no effective anti-alcohol treatment methods that can form a high-quality remission and prevent early relapses. This leads to an increase in social problems.

The author of the project offers his own unique scheme for the treatment of alcohol addiction, using the most advanced technologies and based on modern concepts in medicine. The proposed technique is protected by a patent of the Russian Federation and is modern complex therapeutic methods treatment of alcohol dependence, including infrared photobiostimulation and EHF-therapy, carrying out structural restructuring of cellular metabolism and psychotherapeutic effects, consisting of neurolinguistic programming (NLP) and Ericksonian hypnosis. Infrared photobiostimulation stimulates and activates the system of endogenous opioid neuropeptides and adaptive functions of the adrenal glands, which leads to biological disappearance, relief of alcohol dependence; EHF reflexotherapy is able to completely stop neurovegetative disorders, polyneuropathy, vascular disorders, as well as trophic-metabolic disorders within one or two procedures. NLP carries out a personal transformation of the patient and changes the patient's attitude to the disease, Ericksonian hypnosis in the treatment of alcohol dependence allows you to get therapeutic access to the unconscious and at the level of the unconscious create motivation for sobriety, form an unconscious readiness to achieve results and create a dominant part of the personality responsible for sober behavior. Simultaneous application of NLP and Ericksonian hypnosis makes it possible to successfully overcome alcoholic anosognosia, create an attitude towards treatment and sobriety, stop the primary pathological craving for alcohol and form indifference to the sight and smell of alcohol, as well as new behavioral motives associated with the need to abstain from alcohol.

We have noted that infrared photobiostimulation has such abilities as the formation of artificial stable functional connections of the second type, provides a qualitative relief of the primary pathological craving for alcohol, since selective communication channels are formed in the cerebral cortex and in the subcortical formations of the brain between various subcortical structures of the brain , which are based on long-term memory matrices. This allows in a short time to form structural functional systems of indifference to alcohol. At the same time, NLP and Ericksonian hypnosis enhance the effect of infrared photobiostimulation, which allows the patient to independently realize and work out his deep subconscious reasons for the development of addiction and form a negative conditioned reflex for alcohol.

The advantages of using this method is that it allows you to change the alcoholic attitudes of the personality, while changing these attitudes is carried out directly by the patient, but under the supervision of the attending physician, which allows the patient himself to realize and overcome the pathological patterns of alcoholic behavior and significantly improves the quality of remission. At the same time, after the first session, the pathological craving for alcohol disappears.

Treatment individually takes into account the characteristics of the patient's personality, which increases the effectiveness of treatment. The proposed method of treatment of alcohol dependence does not use drugs, which reduces the cost of the method of treatment.

During the year, 276 people with a diagnosis of alcohol consumption with harmful effects and dependence syndrome, of which - 211 men and 65 women. The course of treatment consisted of three procedures, the interval between which was three days, maintenance sessions were carried out after 3, 6, 9 and 12 months.

After the first procedure, an improvement in well-being was noted in 83% of patients: appetite appeared, sleep improved, mood returned to normal. Obsessive primary pathological craving for alcohol disappeared in 64% of patients. After the second procedure, 72% of patients noted a change in attitude to the sight and smell of alcohol in the form of indifference and indifference. After the third procedure, 96% of those who applied noted that, at the sight of alcoholic products and in the presence of drinkers, the appearance of indifference or aversion to the sight and smell of alcohol. All who underwent the course of treatment noted an improvement in physical well-being: improved sleep, appetite, mood, increased efficiency. At the same time, 14% of patients complained of irritability.

After 3 months, 238 people came to the maintenance session, of which 4 people returned to drinking alcohol, 20% noted intermittent craving for alcohol, which occurs mainly on an empty stomach and disappears after eating. In 30%, recurrent irritation, increased fatigue, decreased performance, worsening sleep were noted. The rest noted persistent indifference and indifference to the sight and smell of alcohol.

After 6 months, 231 people applied. Of those who turned to alcohol, 11 people returned, 17% noted a recurring craving for alcohol that occurs on an empty stomach and during quarrels.

After 9 months, 198 people turned - they all maintained a sober lifestyle and noted the presence of indifference to the type and smell of alcohol.

After 1 year, 216 people applied for a consultation. All those who applied maintained a sober lifestyle and noted an improvement physical health and psychological climate in the family.

The proposed method is suitable for all modern requirements and allows you to qualitatively and effectively stop the main manifestations of alcohol dependence, and is also able to form a high-quality remission.

Bibliographic link

Catad_tema Alcohol addiction - articles

Alcoholism and modern methods of its treatment

Yu.P.Sivolap
Department of Psychiatry and Medical Psychology MALA im. I.M. Sechenov

The adverse health and social consequences of alcohol abuse are serious problem modern society. Alcohol abuse is one of the most significant reasons increase in mortality of the population, as well as morbidity and reduced ability to work.

The results of more than 80 studies prove the relationship between average rates of alcohol consumption per capita and mortality in the population.

In the US, alcohol-associated deaths account for approximately 5% of the total mortality. In the Russian Federation, this figure is significantly higher: according to A.V. Nemtsov (2007), up to 29% of male and up to 17% of female mortality is somehow associated with alcohol consumption.

The list of major alcohol-associated visceral lesions includes the following diseases:

Alcoholic cirrhosis of the liver
alcoholic pancreatitis
damage to the heart and blood vessels (including disorders heart rate, ischemic heart disease, alcoholic cardiomyopathy)
gastrointestinal bleeding

In addition to the listed internal diseases, alcohol abuse leads to damage nervous system manifested by numerous neurological and mental disorders(see below).

Increasing mortality of the population, visceral, neurological and mental disorders associated with alcohol abuse, and the decrease in labor resources that develops as a result of drunkenness turn alcoholism into one of the most expensive diseases for modern society. In the United States, annual economic losses due to alcohol abuse and alcoholism reach $185 billion. .

Epidemiological data

Alcohol, along with caffeine and nicotine, belongs to the “legal triad” of psychoactive substances (PS), the use of which (with certain age restrictions on the purchase of alcoholic beverages and tobacco products) is not prosecuted by law in the countries of European culture.

Unlike banned substances, alcohol is not associated with health hazards for many users. At least 95% of the inhabitants of Russia, Europe and the United States at least sometimes in one form or another consume alcoholic beverages.

Alcoholism is the most common form of substance abuse that requires medical attention and is the reason for seeking medical attention.

Obtaining accurate data on the prevalence of alcoholism in the population is impossible due to the lack of methods for its reliable assessment. According to a number of experts, the proportion of patients with alcoholism in developed countries ranges from 5-12% and is estimated at 10% on average. In Asia and Africa, this figure is significantly lower.

Diagnostic criteria

Alcohol abuse, even in the presence of dangerous medical and social consequences, cannot be considered alcoholism in the absence of signs of alcohol dependence, including mental and physical components.

In accordance with accepted world standards, the diagnosis of alcohol dependence is currently based on a statement of a set of formalized criteria provided for by the ICD-10 and (in North American countries) DSM-IV.

In accordance with the DSM-IV criteria, for the qualification of addiction or dependence on psychoactive substances, including alcohol, it is necessary to state at least three of the following symptoms: 1) tolerance; 2) withdrawal syndrome; 3) constant desire or unsuccessful attempts reduce substance use 4) the use of substances in larger quantities than initially thought; 5) violations of social and professional activities, as well as activities aimed at recreation and entertainment; 6) spending a large amount of time required to obtain substances; 7) continued use of substances despite the resulting problems.

We consider the following basic phenomena to be a necessary and sufficient condition for diagnosing alcohol dependence as the basis of alcoholism: 1) alcohol occupies an inappropriately high place in the hierarchy of values ​​of an individual; 2) the amount of alcoholic beverages consumed always or in most cases exceeds the expected or planned values ​​(loss of control of the dose of alcohol); 3) the use of alcohol continues despite the obstacles that arise, opposition from the environment, the professional and social interests of the individual; 4) alcohol consumption is accompanied by the development of a withdrawal syndrome.

The first three criteria reflect the mental component of alcohol dependence, while the last one reflects its physical component.
The mental and physical components of alcohol dependence are not equivalent in terms of their danger and influence on the dynamics and outcome of the disease.
alcohol tolerance, physical addiction from it, and the withdrawal syndrome as the main reflection of physical dependence does not differ in constancy. Their presence and severity are determined by the phase states of the disease. During the period of stable abstinence from alcohol, physical dependence disappears.

Mental dependence on alcohol is formed earlier than physical dependence and, unlike it, does not disappear even during remission. It is the mental dependence on alcohol (or any other surfactant) that explains the tendency of alcoholism (or any other addictive 1 disease) to an unfavorable course.

Gender specifics

Alcoholism in women develops 3-5 times less frequently than in men. At the same time, in accordance with some data, in recent years there has been a tendency towards a decrease in the difference in male and female morbidity. In particular, it is pointed out that if in previous years among pupils and students alcohol abuse was more common among boys than among girls, now these indicators are equalizing, and in some youth subpopulations drinking girls quantitatively outnumber drinking boys.

In the non-medical environment, there is a stable idea, shared by some experts, about the malignant nature and practical incurability female alcoholism. Other experts (including A.Yu. Egorov and LKShaidukova, 2005) critically evaluate this idea, referring the opinion about the malignant course of female alcoholism due to stigmatization drinking women.

In our opinion, the idea of ​​the malignant nature and incurability of female alcoholism belongs to the category of clinical myths, but at the same time, it cannot be denied that this disease in women in many respects proceeds differently than in men.

Alcohol dependence develops in women later than in men, but is characterized by a more rapid progression. Women seek medical help earlier and demonstrate higher adherence to treatment with slightly worse results.

In accordance with our own observations, the basis of alcohol abuse and alcohol dependence in women is much more likely to be obvious psychological problems than in men. Finally, premorbid borderline mental disorders are detected twice as often (60-70%) in female drinkers than in male drinkers (30%).

Alcohol and the nervous system

Systematic or rare, but massive alcohol abuse in all cases without exception leads to damage to the central nervous system (CNS). Along with damage to the central nervous system, damage develops peripheral nerves(alcoholic polyneuropathy).

Alcoholic damage to the CNS is characterized by pronounced clinical diversity, which, apparently, reflects the complexity of the pathogenetic mechanisms underlying the pathological cerebral processes caused by the action of alcohol, as well as the significant variability of individual types of reactions to alcohol intoxication and metabolic disorders associated with it.

Modern research shows that there are three main pathogenetic factors at the heart of alcoholic CNS damage:

Alimentary (due to malnutrition) deficiency of thiamine (vitamin B 1)
decrease in the content of gamma-aminobutyric acid (GABA) in brain tissue
excitotoxic 2 effects of glutamate

The latter mechanism plays a key role in the development of acute alcoholic disorders and alcoholic cerebral atrophy.

Alcohol abuse leads to an increased synthesis of NMDA receptors, the natural ligand of which is glutamate. The alcohol withdrawal syndrome is accompanied by a massive release of glutamate from its association with receptors and a damaging effect on brain structures. With relatively favorable course of this process, the action of glutamate on nervous tissue is in the nature of "biochemical damage", and in more severe cases, glutamate causes neurodegenerative changes.

Glutamatergic mechanisms play a universal role not only in the formation alcoholic encephalopathy but also in the development of other types of cerebral atrophy, including Alzheimer's disease. The antagonistic effect on NMDA receptors and the resulting antiglutamatergic properties explain the effectiveness of memantine in the treatment of both dementia and, as some studies and our own experience show, in the treatment of acute alcoholic encephalopathy.

Alcoholic damage to the CNS includes numerous psychopathological and neurological symptoms.

In our opinion, from the point of view of pathogenesis, alcoholic cerebral disorders can be divided into typical forms, in the development of which the pathogenetic factors described above (and the neurometabolic changes caused by them) play the main role, and atypical forms.

forms, the genesis of which is largely determined by hereditary predisposition (which is manifested by the presence of mental disorders of the schizophrenic and paranoid spectra in relatives of alcoholics) and the peculiarities of the premorbid constitution.

Typical forms of alcoholic CNS damage include the following states:

alcohol withdrawal syndrome
hangover seizures (alcoholic epilepsy)
typical variants of delirium tremens
Wernicke's encephalopathy
korsakov's psychosis
alcoholic dementia
moderate and erased (subclinical) manifestations of cognitive dysfunction

Atypical forms of alcoholic CNS damage

are presented in the following list:

Atypical (endoform) variants of delirium tremens (including oneiroid and paranoid delirium described by a number of authors)
alcoholic paranoid
acute and chronic alcoholic hallucinosis
alcoholic delirium jealousy

The division of alcoholic CNS damage into typical and atypical forms is not only of academic interest. Typical variants of alcoholic cerebral disorders have the following fundamental differences from atypical forms:

Higher share neurological symptoms in overall structure pain symptoms (eg. neurological disorders in the structure of Wernicke's encephalopathy have a significant preponderance over psychopathological symptoms, and alcoholic epilepsy, in principle, is a purely neurological phenomenon)
higher incidence and severity of cognitive dysfunction
pronounced somatic aggravation of acute psychopathological syndromes
high mortality (capable of reaching 8% in alcoholic delirium and 40% in Wernicke's encephalopathy) The noted differences in the course and prognosis suggest fundamental differences in treatment tactics.

Typical shapes often require intensive care, and in some cases resuscitation approaches, and goals medical measures are the correction of neurometabolic shifts and the support of vital functions.

Treatment of atypical disorders, the main expression of which are endoform psychopathological symptoms, may not have fundamental differences from the treatment of schizophrenia or paranoid syndromes, and antipsychotics are the main means of treating them.

Treatment approaches

The treatment of alcoholism includes two main stages: 1) relief of acute alcoholic disorders; 2) anti-relapse therapy.

Relief of acute alcoholic disorders in

first of all, it includes the prevention or elimination of the withdrawal syndrome and its complications - hangover seizures and alcoholic delirium.

The drugs of first choice in the treatment of alcohol withdrawal syndrome and its complications are the closest analogues of ethanol, pharmacological effects which are due to GABAergic activity - benzodiazepine derivatives. From the group of benzodiazepines, diazepam (Relium), chlordiazepoxide (Elenium) and, with somewhat less efficiency, lorazepam (Lorafen) are primarily used in the treatment of acute alcoholic disorders.

To eliminate the symptoms of alcohol withdrawal and prevent its complications, benzodiazepines are prescribed in sufficiently high initial doses.

The principle of high initial doses is not always observed in Russian narcological practice, which may be due to the fears of doctors due to the possible risk of side effects. However, clinical practice shows that high doses of benzodiazepines prescribed during acute alcohol withdrawal usually do not pose a significant risk to the health of patients, while the ability of these drugs to eliminate acute withdrawal states and in many cases prevent the development of convulsive seizures and delirium tremens does not cause doubt. In those adverse cases of complicated alcoholism, when the development of alcoholic psychosis is impossible, timely prescribed benzodiazepines (as well as other rational therapy, discussed below) can mitigate the course of psychosis and improve its outcome, including, most importantly, increase the survival of patients. alcoholism.

Intravenous diazepam should be considered a risky treatment approach. Alcohol abusers often show hypersensitivity respiratory centers brain to the respiratory-suppressive effect of the drug, and intravenous injection diazepam may cause respiratory arrest. It is also important to take into account that the bioavailability of diazepam when administered intramuscularly is relatively low, which is explained by the peculiarities of absorption of the substance during physiological values pH skeletal muscles. Thus, intravenous administration of diazepam is risky, and intramuscular administration is not effective enough. However, it should be noted that diazepam, prescribed in sufficient doses, in most cases quickly and effectively eliminates acute manifestations alcohol withdrawal syndrome and parenteral administration of the drug, thus, there is no clinical need.

For effective elimination symptoms of alcohol withdrawal and prevention of the development of delirium, diazepam is prescribed at a dose of 10-20 mg, chlordiazepoxide - at a dose of 30-60 mg and lorafen - at a dose of 2-4 mg. After 1 hour, in the absence of the desired effect, the drugs are prescribed again.

The dosages required for the maintenance treatment of alcohol withdrawal syndrome or delirium tremens are given in table.

Along with benzodiazepines, other GABAergic drugs are used in the clinic of alcoholism, namely barbiturates and anticonvulsants - carbamazepine (Finlepsin) and valproates (Depakine).

Along with carbamazepine and valproate, in recent years, more and more wide application in clinical practice, new anticonvulsants are found - lamotrigine (convulsan) and topiramate (maxitopyr). A study of the results of therapy of 125 patients with alcoholism, conducted by E.M. Krupitsky et al. (2009) showed that lamotrigine and, to a lesser extent, topiramate, are comparable to diazepam and superior to memantine in the treatment of acute alcohol withdrawal.

It should be added to the above data that, unlike diazepam and other benzodiazepines, lamotrigine and topiramate do not cause excessive sedation and do not reduce cognitive functions. Moreover, the anti-glutamatergic properties of lamotrigine and topiramate suggest improvement in cognitive functioning similar to, but apparently to a much greater extent, the treatment of cognitive disorders with memantine.

Discovered by E.M. Krupitsky et al. (2009) properties of lamotrigine and topiramate are classified as off label effects and do not yet allow these drugs to be considered as an unconditional alternative to benzodiazepines in the treatment of acute alcohol disorders, however, further studies confirming their safety and efficacy are very likely to be the basis for revision of existing medical standards.

It should be emphasized that GABAergic drugs (and, with some reservations, glutamate antagonists) are characterized by a pathogenetically directed action and, therefore, are considered as the preferred means of treating acute alcohol disorders. The use of neuroleptics for the same purpose as alternative medicines unacceptable for three main reasons: 1) antipsychotics are deprived of the ability to influence pathogenic mechanisms that underlie the alcohol withdrawal syndrome and its complications, and therefore have only an indirect and weak impact to the specified states; 2) neuroleptics increase convulsive readiness, worsen neurological functions and exhibit many other side effects worsening the condition of patients with alcoholism.

A necessary component of the treatment of acute alcohol disorders and prevention (or treatment) acute forms alcoholic encephalopathy is the normalization of biochemical processes in the brain with the help of vitamins. Patients are prescribed thiamine (vitamin B 1) and secondarily other vitamins, including pyridoxine (vitamin B 6), cyanocobalamin (vitamin B 12) and nicotinic acid(vitamin PP).

Therapeutic daily dose of thiamine is 100 mg. In neurologically burdened cases, as well as with Wernicke's encephalopathy (or with the threat of its development), the required daily dose of thiamine is increased to 300500 mg.

In addition to the listed therapeutic measures, the treatment of acute alcoholic disorders includes intravenous drip infusion, the goals of which are rehydration and restoration of electrolyte balance (completion of the deficiency of potassium and magnesium ions).

In list various types infusion preparations, electrolyte (crystalloid) solutions have optimal characteristics. In the use of polyvinylpyrrolidone (hemodez) and glucose solutions (with the exception of relatively infrequent cases of hypoglycemia), there is usually no clinical need. Moreover, the administration of glucose (as well as any other carbohydrates) requires increased doses of thiamine, the deficiency of which in patients with alcoholism is, as mentioned above, a typical phenomenon. In cases where infusion therapy with the help of glucose preparations is still prescribed to patients with alcoholism, this therapeutic measure should be preceded parenteral administration thiamine.

Effective treatment of alcohol withdrawal syndrome involves the observance of three basic principles: 1) the urgent nature of therapy; 2) pathogenetic substantiation in the choice of medicines; 3) the optimal sequence of therapeutic measures.

If the first two principles usually do not raise questions, then the last one, in our opinion, requires a special comment.

characteristic medical error is the appointment of fluid therapy without prior administration of benzodiazepines or other GABAergic drugs. Unlike the latter, infusion therapy per se does not have any effect on the alcohol withdrawal syndrome, and the administration of glucose solutions without appropriate correction with thiamine can, if predisposed, directly provoke the development of Wernicke's encephalopathy.

The main goal of anti-relapse therapy of alcoholism is a stable remission of the disease. In cases where patients with alcoholism, despite the ongoing treatment, are not able to completely stop drinking alcohol and the designated goal is unattainable, therapy is supportive, and its goal is to improve the course of the disease, namely, reducing the frequency and severity of alcoholic excesses, preventing binges and mitigation adverse effects alcohol abuse.

Anti-relapse (maintenance) therapy of alcoholism in most developed countries, it is carried out with the use of three main drugs: disulfiram, naltrexone and acamprosate.

Disulfiram is classic remedy aversive treatment of alcoholism. The pharmacological activity of disulfiram is based on the irreversible suppression of the activity of acetaldehyde dehydrogenase, an enzyme that catalyzes the conversion of acetaldehyde to acetate (acetic acid). The accumulation of acetaldehyde in the body under the influence of disulfiram when drinking alcohol leads to the development of "acetaldehyde syndrome", or disulfiram alcohol reaction (DAR).

DAR is characterized by the following clinical manifestations:

Increase in blood pressure
tachycardia
heartbeat
throbbing pain in the head
blurred vision
nausea and vomiting
shortness of breath and feeling short of breath

The most obvious symptom of DAD is reddening of the skin, and the main manifestation of the aversive effect of disulfiram and its most useful therapeutic effect is the fear of death, which successful therapy forces an alcoholic to stop drinking alcohol.

The initial (during the first 5 days) daily dose of disulfiram is usually 800 mg. For further maintenance therapy, it is recommended to take disulfiram at a daily dose of 400 mg, usually 200 mg 2 times a day. In some cases, the drug is prescribed at a dose of 800 mg every other day (or 3 times a week).

The duration of aversive therapy with disulfiram is usually determined by clinical need. In some cases, it is advisable to use short courses in situations that can provoke another alcoholic excess.

Unfortunately, despite the use of any therapeutic approaches, the treatment of alcoholism is characterized by low efficiency, which is determined by a number of reasons, including the weak motivation of patients for treatment and, consequently, their insufficient desire (compliance) to follow medical recommendations. In accordance with the opinion of some experts (the legitimacy of which is confirmed by our own clinical observations), compliance with disulfiram treatment and, therefore, the effectiveness of therapy can significantly increase when the drug is controlled by relatives, primarily spouses of alcoholics.

Innovative and very successful dosage form disulfiram are, in our opinion, water-soluble (“effervescent”) tablets produced by Actavis under the classical name Antabuse.

The solubility of Antabuse in water in the absence of taste and smell allows the relatives of the patient (in the absence of risk serious complications DAR) to add the drug to food or drink in cases of potential effectiveness of therapy when the patient refuses treatment.

Thus, each intake of a soluble tablet, unlike the usual one, will ensure a reliable intake of the drug into the patient's body.

In addition, the rapid entry of the drug into the blood, provided by this dosage form, implies the timely development of a clinical effect, which can be of unconditional importance in the practice of treating alcoholism.

Antabuse tablets are available in two types of 200 and 400 mg, which corresponds to the above doses recommended for maintenance therapy.

Apparently, many practical narcologists are familiar with a phenomenon that can be defined as the “sinusoid effect” and which reflects fluctuations in the effectiveness of the treatment of alcoholism (and, probably, some other diseases) with the help of different drugs. The appearance of a new drug is usually accompanied by an increase in the effectiveness of treatment, including due to the peculiar placebo component of its action. Then, after the inevitable accumulation of cases of unsuccessful therapy and the formation of a more negative perception of the drug or method of treatment among patients and their relatives, the effectiveness of treatment decreases in order to increase again after a few years with increasing interest in a less commonly prescribed and therefore “forgotten” drug. The dynamics of popularity and, to a certain extent, indirect psychological factors The clinical efficacy of drugs thus acquires the character of a sinusoid. In accordance with our observations, the popularity and, therefore, the potential clinical effectiveness of aversive therapy for alcoholism is currently experiencing another rise, and the emergence of new form disulfiram in the form of soluble tablets, of course, can significantly expand the possibilities of practitioners in the anti-relapse (maintenance) therapy of alcohol dependence.

Along with pharmacological therapy, psychotherapy and other non-drug approaches are used in the treatment of alcoholism. In accordance with the WHO treatment standards, cognitive and behavioral psychotherapy is considered to be the optimal psychotherapeutic approach in the treatment (as well as other addictive diseases).

It should be noted that the combination of psychotherapy and pharmacological therapy alcoholism can increase the effectiveness of the latter due to a more successful realization of its potential.

1 From English. addiction "addiction".
2 From English. excitement "excitation" and toxic "toxic".

Literature

1. Egorov AYu, Shaidukova LK. Modern Features alcoholism in women: age aspect. Narcology. 2005; 9:4955.
2. E.M. Krupitsky, A.A. Rudenko, and A.M. Burakov. Comparative effectiveness of the use of drugs that affect glutamatergic neurotransmission for the relief of alcohol withdrawal syndrome. Review of Psychiatry and Medical Psychology. VMBektereva, 2009; 1:37433. Nemtsov AV. Alcoholism in Russia: history of the issue, current trends. Journal of Neurology and Psychiatry named after S. Korsakov. 2007; Alcoholism (supplement), issue 1:37.
4. Sivolap YL., Savchenkov VA, Yanushkevich M.V., Yakovchuk AM. Clinical observation favorable outcome of Wernicke's encephalopathy. Review of psychiatry and medical psychology named after V.M. Bekhterev. 2006; 2:289.
5. Ballinger A, Patchett S. Saunders" Pocket Essentials of Clinical Medicine. 3rd ed. Edinburgh, Elsevier, 2005.
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12 Semple D, Smyth R, Burns J et al. Oxford Handbook of Psychiatry. New York: Oxford University Press, 2006.

Hippocrates called alcoholism "voluntary madness".

If the “alcoholic madness” were actually voluntary, then, probably, this would greatly facilitate the work of doctors. There would be no need for medicine at all. It is enough for a person to “lose desire” - and he is no longer an alcoholic.

But in fact, one can speak about voluntariness and, in general, about some kind of will only at the stage of domestic drunkenness.

If alcoholism is diagnosed, the patient is almost no longer responsible for his thoughts and actions. They are formed under the influence of pathological attraction. Mental and physical dependence is formed - the brain and internal organs can no longer function comfortably without another dose.

To defeat a terrible disease, modern effective methods of treating alcoholism are needed. Currently, there are schemes that help to “pull out” a person from the sticky tentacles of addiction, even in the most seemingly hopeless cases. Below we will talk about the main directions and methods of treatment of alcoholism, which are used in our clinic.

What effective treatment for alcoholism usually begins with: withdrawal from binge

We have a separate article on this topic, but here we list only the main effective methods of treating alcoholism using coding:

• Filling a capsule with a disulfiram-based drug: Esperal or Torpedo
• The use of drugs for intravenous and intramuscular injection: Aquilong and Algominal
• Use of opioid receptor blockers in the brain: Vivitrol

What is the most effective remedy from alcoholism from listed above? Selection is always carried out individually by the treating narcologist.

The most effective remedy for alcoholism: Rehab

Many patients decide that after coding they become healthy. And they are very wrong. The main problem of alcoholism is a strong mental dependence and the impossibility of "cultural" consumption of ethyl alcohol. The patient recovers ONLY after:

• he understands that he is ill, and realizes the essence of his illness;
• finds his place in life, becomes necessary and happy (and in many respects it depends on him!);
• learns to cope with problems and stress on his own, takes responsibility for his life.

There is no "magic pill". Detox therapy, coding, all, even the most effective types of binders, are just preparation for the final, most difficult and important stage.

There is a modern method of treating alcoholism called "12 steps". It is carried out in specialized rehabilitation centers. Under the guidance of an experienced psychotherapist, the patient rebuilds relationships with himself and the outside world. He learns to recognize his illness. Learns to deal with guilt and others uncomfortable sensations. Understands his goal, decides how he will lead a healthy and full life in future.

There are no former alcoholics. You can’t get sick, then code, wait a couple of years, and start drinking only on holidays, “like everyone else.” From now on, for a person, every tiny glass can be the beginning of something more, namely, a relapse and a return to the disease.

Unfortunately, many perceive rehabilitation in a completely different way. Most often, they talk about it as something additional and not mandatory. Of course, this is not true. Any narcologist will confirm.

Above, we tried to tell you in as much detail as possible about all the methods of treating alcoholism. Chances are you still have a lot of questions.

Give us a call and we will definitely answer and help.

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Alcoholism is an irresistible craving for the regular use of alcoholic beverages. Many claim that they are able to drink a lot and constantly, without having any addiction. But, nevertheless, these people do not think about how to stop and constantly increase the dosage. This is how the imperceptible formation of alcoholism occurs.

What is the way out of this situation?

It is quite possible to cure it using traditional and proven methods, but awareness plays an important role in this. drinking man existing problem. Without his sincere desire to recover, nothing will work.

All people are different from each other, and the formation of alcohol dependence for everyone occurs in different ways - for some it is faster, while for others it is slower. A person who drinks regularly will sooner or later face this problem.

It is impossible to draw a clear line between those people who drink normally and those who are addicted. Alcoholism does not arise suddenly, it slowly draws in its degrees and the person assures both himself and those around him that he can stop drinking at any moment. Few people have the true courage to admit this addiction to themselves first.

The extent to which a person is prone to alcoholism depends on many factors. This and life values and the culture of education, and the level of employment. But with all this, it should be remembered that alcohol addiction is primarily a disease, and its treatment requires both a special approach and the support of loved ones and specialized medical care.

If a person who has suffered from alcoholism recovers, he will still never be able to drink alcohol, even in the most minimum doses. If in the body former alcoholic at least a drop of alcohol gets in, special biochemical mechanisms are launched that increase the desire to drink more. So even after treatment, there may be a loss of control over alcohol consumption. Therefore, a person who wants to be cured must forever give up alcoholic beverages.

Doctors assure that recovery is possible regardless of the stage of alcoholism. And the main guarantee of success is the desire of the patient, which in one way or another can be stimulated by his relatives.

The hardest part of treating alcoholism is the first step. The patient must gather strength and hold out without alcohol for at least a week or two. The success and effectiveness of therapy depends on this.

What are the most effective modern methods of treating alcoholism?

Traditional treatment for alcoholism

It implies constant contact with the patient. He needs to explain the purpose and method of carrying out all procedures, as well as all the necessary actions of him as a patient. In no case do not trust treatment to various charlatans who lure relatives of an alcoholic with promises of non-contact therapy. At best, it will end up with just a loss of money.

First of all, the patient should refrain from drinking alcohol for several weeks. This is one of the most difficult steps.

Traditional treatment can be carried out on the basis of various methods. It can be special medicines, psychotherapeutic sessions. Most often, treatment is complex and is designed, firstly, to form an aversion to alcohol, and secondly, to raise self-esteem and teach a person auto-training techniques.

The body of an alcoholic is cleansed of traces of alcohol, saturated with vitamins and intoxication is removed. This stage is necessary for the removal of toxic products of the breakdown of alcohol.

Psychotherapy offers the following treatments for alcoholism:

NLP
twelve step methodology
gestalt therapy
SMIL

Official medicine allows the use of funds traditional medicine for the treatment of alcohol dependence. Most often, it is recommended to take various herbal preparations and holding sessions special massage. All of these treatments should be discussed with your doctor beforehand.

TES therapy

TES therapy for alcoholism is very popular. This technique consists of a certain complex of psychotherapeutic and medical methods. TES therapy involves the impact on the human brain with the help of special impulses. They reduce and nullify the activity of those areas of the brain that are responsible for the desire to drink, while simultaneously stimulating the work of areas of self-control.

This technique is now considered one of the most effective. A person's craving for alcohol disappears, instead of which there is a surge of strength, good mood and strong healthy sleep. Restoration of memory, ability to work and attention is also observed.

TES therapy does not affect the subconscious of a person and does not aim to change it. The personality does not change and the patient does not feel dictatorship and full control doctor. But, nevertheless, the repeated use of alcoholic beverages leads to breakdowns, since the body forever stores information about alcohol. In this case, treatment should be started from the very beginning. And again, the desire of the patient comes to the fore, he must himself want to get rid of bad habit.

Of course, the treatment of alcoholism is best done on early stages.

Alcohol addiction treatment can be done at the same time as traditional methods as well as traditional medicine. The conditions for such treatment of alcoholism should be discussed with your doctor beforehand.