Statistics show that about 34% of Americans abuse alcohol at a rate which they can be termed as alcohol dependent. The statistics also show that alcohol dependence causes about 100,000 deaths every year in the U.S. It is estimated that over $184 billion is spent every year in the United States for abuse of alcohol and treatment of the injuries and diseases which result from such abuse.
For the people who abuse alcohol but are not yet dependent, primary care interventions and screening tools reduce the problem of abusive drinking. In most alcohol dependence treatment centers, the 12-step programs and counseling are generally accepted as the standard forms of alcohol dependence treatment. The pharmacological treatments are mostly used as adjunctive therapies.
The medications that are recommended for alcohol dependence treatment are used as adjunctive remedies. At the moment, only three types of medications (acamprosate, naltrexone, and disulfiram) are approved by the FDA for this purpose. DISULFIRAM is an aversive agent which has been used in treating alcohol addiction for more than four decades. It has compliance difficulties and some significant side effects.
It is believed to reduce the craving for alcohol, decrease rates of relapse and increase rates of abstinence. It inhibits acetaldehyde dehydrogenase. After taking the drug, the patient is likely to experience severe adverse side events, such as:
The patient may also experience some unpleasant feelings if taking the drug together with metronidazole.
On the other hand, NALTREXONE has been proven to increase the rates of abstinence and the rates of cravings and relapse. It is an antagonist of opiate receptors. It is an effective treatment of alcohol dependence if it is used in the proper conjunction with recommended psychological interventions.
It works by locking the opiate receptors, causing a reduction in the alcohol’s reinforcing effects and a decrease in the feelings of craving. It also causes a great reduction in the craving for alcohol. The drug is generally well tolerated by most patients, but it has some side effects.
Acamprosate (calcium homotaurinate) reduces the rate of relapse and increases that of abstinence. It has also been approved by the FDA for alcohol dependence treatment. Some doctors also prescribe anticonvulsant agents in alcohol dependence treatment. This drug is generally very well tolerated but it has some mild side effects. The drug should not be taken by people who have serious problems of the liver, such as liver cirrhosis.
Although the FDA has not approved the anticonvulsant agents in alcohol dependence treatment, the anticonvulsant topiramate and various other Serotonic Agents, such as ondansetron and fluoxetine, have, in recent studies, showed effectiveness in increasing the rates of abstinence and decreasing the craving for alcohol.
There are ongoing studies about the effectiveness of these agents in alcohol dependence treatment, but there are some inconsistent results. These two types of drugs are generally well tolerated. To prevent relapse, the treatment with any drug should be undertaken together with concurrent counseling and other self-help programs.