Alcohol is the most commonly used addictive substance in the United States. The term “Alcohol use disorder” is a medical diagnosis given, when the drinking problem becomes severe. It is a chronic relapsing brain disease, which involves obsessive alcohol use, unable to control its intake and followed by undesirable emotional state once abruptly stopped.
Alcohol use disorder results from a variety of genetics, psychosocial and environmental factors:
Symptoms for alcohol use disorder includes:
- Chronic alcohol use over a 12-month period resulting in significant impairment, psychosocial problems and physiological distress, associated with the development of tolerance, drinking that prompts risky situations or the development of withdrawal symptoms.
- Intense alcohol consumption, despite its use leading to numerous adverse effects such as, medical, psychiatric and psychosocial.
- According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use causes 88,000 deaths a year.
- More than one third of young adults in 2104 were binge alcohol users (37.7%) and about 1 in 10 were heavy alcohol users (10.8%)
- Underage alcohol use (aged 12 to 20) and binge and heavy use among young adults aged 18 to 25 have declined overtime but remain a concern.
Different levels of drinking are as follows:
- Moderate Drinking: 1 drink per day for women and up to 2 drinks per day for men (Dietary Guidelines for Americans).
- Binge Drinking: 5 or more alcoholic drinks on the same occasion on at-least 1 day in the past 30 days and produces blood alcohol concentrations of greater than 0.08g/dl (SAMSHA / National Institute on Alcohol Abuse and Alcoholism – NIAAA).
- Heavy Drinking: 5 or more drinks on the same occasion on each of 5 or more days in the past 30 days (SAMSHA).
Medications for Alcohol Use Disorder
- Naltrexone: It blocks the effects of opioids that are involved in the rewarding effects of drinking and the craving in those with alcohol use disorders. Vivitrol-an extended release injectable form administered once a month is approved by FDA, for treating alcoholism and may offer compliance benefits.
- Acamprosate: It reduces symptoms of prolonged withdrawals and has been shown to help alcoholics to maintain abstinence for several weeks to months. It may be more effective in patients with severe alcohol dependency issues.
- Disulfiram: It inhibits the alcohol metabolism in the body, resulting in an unpleasant reaction such as, flushing, nausea and palpitations if a person takes the medication and then consumes alcohol. Though, among patients who are extremely determined, disulfiram can be very effective.
- Topiramate: It is an anti-seizure medication, which is usually prescribed to epileptic patients. Few studies have shown its effectivity in helping alcohol-dependent people to stop drinking. The exact mechanism is unknown; however, it is thought to work by increasing inhibitory (GABA) neurotransmitters and reducing stimulatory (Glutamate) neurotransmitters. Since topiramate has not received FDA approval for treating alcohol addiction, it is used off-label for this purpose.
This document is created by Azmeena Hashem (Doctor of Nursing Practice, NP-C)