Alcoholism—a disease, not a bad habit.

Alcoholism represents a devastating addiction that, in the end, ruins people’s lives. It is seen as a chronic condition that must be dealt with carefully. When treating and aiding an alcoholic, the best approach is professional treatment combined with therapy and support groups. Nowadays, there are more and more cases where medication is highly recommended. One of the medications prescribed is called Antabuse (Disulfiram), and it is said to be highly beneficial to the patient. It was used as a remedy for heavy drinkers and was one of the first medications authorized by the FDA and used in dealing with alcoholism.
Alcohol addiction turns out to be a problem when a person cannot survive without it and when alcohol consumption stops an individual from living an active, healthy, and happy life.

The medical condition when the overpowering craving for spirits prevails and the ability to avoid consumption is usually called alcohol addiction. Like other dependencies, alcohol addiction may be tremendously difficult to fight, and an individual may experience difficulties even accepting the existence of this problem.

What is alcoholism/alcohol addiction?

Alcohol addiction is indicated by a decrease in control over consumption. Nаturаlіѕtіс аnd long tеrm fоllоw-uр ѕtudіеѕ show thе rесurrеnсе оf hаrd drіnkіng еvеn after dесаdеѕ оf thе аbѕtіnеnсе. Relaxing of hard drinking has also been demonstrated in animal studies in which long-term forced abstinence had been maintained. Finally, although most clinicians have suggested abstinence as the first target, there is growing interest in reducing severe drinking for patients whose target is not abstinence. Follow-up studies on alcoholism have indicated that most people can’t manage their consumption of alcohol. There are different opinions on whether this effect could also be seen in people who are dependent on alcohol. Studies that focused on cognitive behavioral therapy (CBT) found some positive results with self-control efforts in people who had a re-established alcohol problem compared to a non-treatment group.

Alcohol addiction—etiology, pathology, development, and treatment

Disulfiram has become the most popular treatment for alcohol addiction. The overall lifetime prevalence of alcohol dependence is about 7%–12.5% in the Western population. The treatment of biological alcoholism consists of dealing with alcohol intoxication, withdrawal symptoms, and neurological disorders related to alcohol as well as the achievement and maintenance of abstinence. In the last twenty years, many treatment methods have been implemented for patients.

Causes of alcohol addiction

Numerous physical, environmental, emotional, and social factors may stimulate the development of alcohol addiction treatment in Philadelphia. The list of these factors includes:

• peer pressure;
• inherited factors and family history of alcohol addiction;
• the desire to hide internal domestic and family issues;
• chronic stress conditions.

Alcohol Addiction Symptoms

• tenacious consumption of spirits;
• a resilient craving to consume alcohol;
• inability to control the amount of alcohol consumed;
• fluctuations of the frame of mind;
• deficiency of attentiveness;
• insufficient ability to memorize;
• going up or down tolerance to spirits;
• the absence of interest in anything other than drinking life events.

Somatic symptoms accompanying alcohol addiction are the unsettled stomach, perspiring, nervousness, and trembling.

Mechanism of Alcohol addiction.

Alcohol dependence may result in broken relationships due to the drunk person’s inappropriate (aggressive, wild, physical) behavior. People with a dependency on alcohol very often become indifferent to their career development and financial status. Apathy is a common reaction to the outside world for individuals suffering from alcohol addiction.

Many of them even have suicidal thoughts. If this is the case, professional medical (mental) care is necessary to control the further development of the pattern. Most of the people who are free from alcohol addiction cannot even accept the fact that someone is unable to stop drinking and “agree” to lose a job, money, family, love, etc., in exchange for a drink. In reality, however, a necessity for alcohol consumption in addicted individuals is as mandatory as a necessity for a healthy person to drink water or to eat food. At some point, many addicts experience an emotional state of remorse, embarrassment, and regret. They understand the necessity of breaking the pattern. However, the physiological aspect of this disorder keeps them in the same state, causing even deeper depression.

What is the edge between normal drinking and alcohol addiction?

Consuming a reasonable amount of spirits does not point to alcohol addiction. Lots of people drink alcoholic beverages and still are not addicted to them. Government recommendations claim that females consume less than three drinks daily and males drink less than four. One “drink” is virtually compatible with 25 ml of hard alcohol beverages (cognac, vodka, rum), 125 ml dry wine, or 16–22 oz. of beer.

It is a known fact that the excessive consumption of alcohol may cause or deteriorate the development of some pathological medical conditions. Those conditions include hepatic cirrhosis, cardiac diseases, melancholy, nervousness, and brain impairment. Studies suggest that nearly a quarter of males and 15-17 percent of females consume some spirits, sufficient to significantly increase the risk of developing different medical disorders associated with alcohol.

Treatment approaches for alcohol addiction.

Various psychological interventions, including psychotherapy, are effective in treating alcoholism. The long-term аbѕtіnеnсе rаtіо hаѕ rаrеlу exceeded 40% wіth these trеаtmеntѕ. The effective treatment strategies are CBT, which increases the motivation for recovery; twelve-step treatment; various therapeutic approaches of family, social environment, and marriage; and training for social skills. Psychodynamic therapies are less preferred—after alcohol detoxification, a standard treatment strategy for maintenance in alcohol dependence is lacking.

The use of Disulfiram, also known as Antabuse in the management оf alcohol dереndеnсе bеgаn іn 1948 and was аррrоvеd bу thе Fооd аnd Drug Administration (FDA) fоr the trеаtmеnt оf аlсоhоlіѕm іn 1951. The effectiveness of this technique is limited by the patient’s motivation to comply with treatment. Fuller et al. have shown in their study on male alcoholics that Disulfiram was not found to be superior to placebo in terms of the delay to the first drink or improvement in social and professional consequences.

Disulfiram for Alcoholism

The main reason for ineffective treatment was linked to inappropriate usage of the drug, and the results of urine analysis showed that only 20% of patients were fully compliant with Disulfiram treatment. Lundwall and Baekealand reported that only one study had adequate design criteria among more than forty studies about Antabuse, which were conducted between 1948 and 1971. In a different meta-analysis study, Garbutt and colleagues said that out of 135 studies about the age of oral defecation, only five had a control group. They also said that the results of the studies were similar and could be used to investigate the relapsing issue.

Due to these research results, it has been reported that the power of Antabuse studies is low and the main methodological difficulties have been reported to be the absence of blind studies, the lack of samples assessing treatment compliance, short follow-up periods, and non-random sample selection. Recent open-label studies have shown that disulfiram is superior to асаmрrоѕаtе, nаltrеxоnе, and tоріrаmаtе. Eѕресіаllу fоr іndіvіduаlѕ consuming аlсоhоl fоr a long time, dіѕulfіrаm hаѕ bееn сlаіmеd to be superior tо other trеаtmеntѕ. Petrakis and colleagues studied alcohol-dependent people who also had a psychiatric disorder, a PTSD disorder, or major depression. They found that naltrexone, ulfaram, and combination therapy worked better than a placebo. However, there was no significant difference between the drug groups in terms of how well they responded to treatment. For patients with depression, Antabuse was found to lower craving scores.

In recent years, it has been discovered that disulfiram significantly affects the noradrenaline and dopamine pathways. Possibly because of these effects of disulfiram, there are growing research findings indicating that Antabuse might be used safely for alcohol-dependent individuals who have comorbidities with social dependence or pathological gambling.

Antabuse also can be used safely in combination with other medications treating alcohol dependence, such as Acamprosate, naltrexone, and Topiramate, and it may be effective alone for adolescents with alcohol abuse and dependence. When combined with асаmрrоѕаtе, the total efficiency increases significantly. Poor adherence/consistency is a major problem with Disulfiram treatment; it has been shown that most patients have left treatment within a few months. Therefore, діѕulfіrаm trеаtmеnt іѕ аdvосаtеd tо be uѕеd under ѕuреrvіѕіоn or аdult рrоbаtіоn. A meta-analysis of 13 controlled and 5 non-controlled trials found that disulfiram groups under supervision or probation were more likely to reduce alcohol use and stay in treatment compared to unsupervised treatment groups and patients who were not taking Antabuse.

 A recent meta-analysis published by Jоrgеnѕеn and соllеаguеѕ in 2011, which was based on a review of 11 studies with 1,527 patients, shows that sustained treatment with disulfiram is very effective in maintaining short-term abstinence, increases the number of days to relapse, and leads to a significant decline in total drinking days. Subdermal implantation of disulfiram, which releases the drug continuously, has been developed to improve compliance. Marie used the implantation method for the first time in 1955. As research has shown that abstinence lasts longer with disulfiram implants than with oral disulfiram, it has been suggested that disulfiram implants might be better as a maintenance treatment. Disulfiram implantation provides a controlled release of disulfiram into the blood, which results in the disulfiram-ethanol reaction upon alcohol intake. The commonly used disulfiram implant dose is 1 g.

Disulfiram-Ethanol Reaction against alcoholism.

Disulfiram inhibits the enzyme “acetaldehyde dehydrogenase” and increases blood acetaldehyde levels following alcohol intake. Immediately after drinking, the disulfiram-ethanol reaction manifests with flushing, sweating, and severe headache. At a moderate level of intensity, the reaction causes nausea, tachycardia, palpitation, hyperventilation, hypotension, and dyspnea. Vomiting, respiratory depression, cardiovascular collapse, arrhythmia, myocardial infarction, acute congestive heart failure, unconsciousness, convulsion, and death may occur in the more severe case of Disulfiram-Ethanol reactions. The mild and moderate reaction levels may occur when the blood alcohol concentration reaches 10 mg/dl and 50 mg/dl, respectively. It has been suggested that the development of the Disulfiram-Ethanol reaction at the initiation of treatment did not affect treatment response. New findings of the clinical and sociodemographic factors contributing to Disulfiram efficacy will guide clinicians in this field. For this purpose, we have evaluated the duration of abstinence and complication rates and have determined the relationship between these findings, sociodemographic characteristics, and spirits drinking patterns in the patients with alcohol dependence who were hospitalized and had implanted Disulfiram.

How to take Antabuse/Disulfiram for alcohol addiction control?

      Your desire to start taking Antabuse is because you want to completely stop alcohol consumption; after you might have failed to do so, relying on your will, passion, and determination. Before starting 

For disulfiram treatment, you must visit your physician to inform him/her and take into consideration all professional 

advice seriously. However, you must know that Antabuse is a drug that goes against any form of alcohol or ethanol in your body system by causing reactions that are cruelly “unpleasant.” This means you must always be cautious of anything you take as food or drink. Some foods or drinks contain alcohol in small percent, and such is not suitable for you if you want to prevent being down with dizziness or any reactions caused by Disulfiram or Antabuse.  Even some drugs, including cough syrups and cold formulas, contain alcohol and may lead to a disulfiram ethanol reaction. Be sure to stay away from some standard ethanol-containing products: mouthwash, perfumes, colognes, even vinegar, aftershave, antiperspirant, antiseptic, astringent skin products, hair dyes, and similar because they often contain alcohol. However, Antabuse is good enough to solve your alcoholism problem if taken as prescribed by doctors.

Side Effects of Antabuse

All pharmaceutical drugs, including Disulfiram or Antabuse, have many side effects. To achieve an alcohol-free state of life, you have to be aware of the possible side effects of Disulfiram.

1. Antabuse can cause weakness or tiredness, especially during the first few weeks of intake.
2. Antabuse can also lead to changes in a mouth in the form of a swollen tongue, causing a metallic or garlic-like taste, especially within the first few months of intake.
3. Antabuse may flare up skin rash or acne.
4. There are known cases when Antabuse leads to erectile dysfunction.
5. If taken for a long time, Antabuse can cause damage to a patient’s liver. This is the most common and significant side effect of Disulfiram. With the intake of Antabuse, about five people out of 1,000 develop severe liver damage.
6. Kidney failure is another severe side effect of the drug.

     The significant side effects of Disulfiram are liver and kidney damage, especially if a patient had relevant medical conditions in the past. Kindly inform your doctor about your medical history before taking Disulfiram. You may be prevented from taking Antabuse if you have a significant medical history of heart or coronary vessel disease, diabetes, an underactive thyroid, brain disorders (e.g., seizures, brain damage), chronic kidney and liver diseases, a history of severe depression, a history of bipolar psychosis, or a history of suicide attempts. Disulfiram, the active ingredient of Antabuse, can alter the metabolism and blood levels of certain drugs, especially tricyclic antidepressants, Dilantin (phenytoin), Coumadin, isoniazid, and theophylline.

The pros of using Disulfiram pills are the strength of the Disulfiram-Ethanol Reaction.

The cons are

• If a patient decides to consume alcohol, he/she may skip a daily pill of disulfiram
• Disulfiram taken daily toxifies the patient’s body and may cause permanent damage to the internal organs and systems.

Treatment for Alcoholism in Philadelphia

One of the significant downsides in the USA is that until recently, you could only get prescribed the Antabuse pills. However, Implants, mostly known as Esperal in the US, began to be used more frequently in centers dealing with severe forms of alcoholism. Regarding Philadelphia, the Esperal implant is available in only one place. Victor Tsan allows his patients to benefit from this interventional medical approach at the Philadelphia Addiction Center. As a part of alcoholism treatment, Victor Tsan implants the French-made device Esperal into patients’ bodies, which boosts the effectiveness of the treatment up to 100%. This implant’s beauty is that it creates a habit of not drinking for the patient. Implantation of the Esperal helps deal with alcoholism because it allows the patient to discover that he/she can have an everyday life without abusing alcoholic beverages.

Most individuals suffering from alcohol addiction are trying to mask it from society. Also, many people do not even accept that they are addicted. As a result, alcohol-addicted people do not usually undergo any treatment and allow the disease (alcohol addiction) to progress.

At the same time, numerous alcoholics can reconstitute their lives and govern the addiction pattern with the correct case management and support.

Hypnotherapy in different forms is the leading method of treatment of addictions in general and alcohol addiction in particular. Hypnotherapeutic induction allows a practitioner to contact a patient’s subconscious mind and expose the core source of the disorder. In many cases, the hypnotherapist may perform a life regression procedure to understand when and why the patient had the 1^st drink in a lifetime. By placing the patient in that “virtual pastime,” the clinical hypnotist may virtually prevent the individual from drinking the very first shot, and when the patient returns from the trance, the recollection of the drinking habit is wiped out.

To schedule your appointment for a free phone consultation and talk to Victor Tsan about your treatment options, contact our clinic at (267) 403-3085