It was long believed that 1-2 alcoholic drinks daily promoted good health, especially for the heart.
It was long believed that 1-2 alcoholic drinks daily promoted good health, especially for the heart. New information shows that alcohol is carcinogenic (cancer causing) and that there are no benefits medically from consuming alcohol. People who drink too much are at a significantly higher risk of heart failure, dementia, neuropathy, high blood pressure and cirrhosis of the liver There are benefits from drinking alcohol, including being more social with drinking but overall the net result for most people is negative.
Quitting alcohol can be a problem. Quitting daily use can result in life threatening side effects such as the DT’s (delirium tremens). If you develop shaking or other withdrawal symptoms you should seek medical attention right away. Benzodiazepines (like Valium) are usually first line treatment, the epilepsy medication Tegretol (carbamazepine) can also block the withdrawal.
12 step programs like AA (alcoholics anonymous) and others have a good track record of getting people to successfully quit. Sponsors often get more benefits than AA alone. Individual counseling is needed as well.
There are FDA approved medications to help with alcoholism:
1) Naltrexone is effective in reducing heavy drinking. It reduces craving for alcohol and makes alcohol less pleasurable. It shouldn’t be used for patients with liver disease or taking opioids for pain. The dose is 50mg/day orally or a long acting injection of Vivitrol 380mg monthly.
2) Campral (acamprosate) 666mg three times daily. Most effective for maintaining abstinence rather than decreasing heavy drinking. It decreases post withdrawal anxiety. Can’t be used in those with significant kidney disease.
3) Antabuse (disulfiram) turns alcohol into the equivalent of embalming fluid. It makes the patient very sick so they won’t impulsively drink any more. Effects can last a week. Absolutely no alcohol in or in your body while you take this medication
Non FDA approved medications include:
1) Topamax (topiramate) shows a decrease in heavy drinking days and an increase in abstinence days. Dose is slowly moved up from 25mg daily to 150mg twice daily. Side effects can include mental slowing, weight loss, and numbness/tingling. It can be started while the patient is still drinking.
2) Gabapentin has increased rates of abstinence and a decrease in heavy drinking. The recommended dose is 1800 mg/day. Side effects include sedation and dizziness. Combining gabapentin with naltrexone is more effective than either medication alone.