Mental Health Care

Most people who suffer from alcohol dependence or alcohol abuse are reluctant to take any treatment. In fact, most of them deny the problem. Since alcohol has serious health and social consequences, there is a definite need for them to be pressured to give up drinking. Some habitual drinkers seek treatment when they run into health or legal problems. If you are concerned about a friend or family member, go ahead and take a pro-active role and discuss the possibilities with a physician who specializes in de-addiction therapy.

There is a wide range of treatments available and they need to be tailored to the needs of the individual. The treatment must begin with a total evaluation, estimation of the severity of the dependence, counselling and management as an outpatient, or a residential inpatient stay.

The first step is to try and determine the extent of the problem. If a person has not lost control over the use of alcohol, the treatment may involve simply motivating the person to stop. This can be achieved with the help of counselling or a brief intervention. Effective treatment is impossible unless the person accepts that he or she is addicted and is unable to control drinking. The intervention usually involves alcohol-abuse specialists who can establish a specific treatment plan. Interventions may include goal setting, behavioural modification techniques, use of self-help manuals, individual and group therapy, participation in self-help groups, educational lectures, family involvement, activity therapy, counselling, and follow-up care at a treatment centre.

If the person has lost control and has turned into an alcoholic, the above listed steps alone are generally not sufficient and the beginning of a successful abstinence programme requires active surveillance under a specialized residential treatment facility or a separate unit within a general or psychiatric hospital. The treatment begins with detoxification. This usually takes up to a week, and the patient may need medications, such as diazepam to prevent delirium tremens and to treat other withdrawal symptoms. At the same time, steps are taken to provide the patient with adequate nutrition and rest. The patient often needs good amounts of multiple B vitamins. Each patient also requires a complete health check up. Chronic alcoholics are known to develop high blood pressure, increased blood sugar and liver and heart disease, and need active treatment.

Once the patient recovers from acute withdrawal symptoms, the process of rehabilitation must begin. Group and individual counselling, and psychological support can keep the motivation level high and reinforce the resolve to abstain. The family and friends also need to know that they must stop protecting the patient from the problems caused by alcohol. Those who are weak-willed; but have a desire to stop may take help of medications. An alcohol­sensitizing medication called disulfiram (Antabuse) may be useful. If a person drinks alcohol, the medication produces a severe physical reaction that includes flushing, nausea, vomiting and headaches. Disulfiram will not cure alcoholism nor can it remove the compulsion to drink. But it can be a strong deterrent. Naltrexone, a medication long known to block the narcotic high, can also reduce the urge to drink. It may, however, lead to serious side effects, including liver damage. These medications cannot be given to a person who is not willing to stop.

While the person makes a recovery, they must also return to useful and active life. This may require vocational rehabilitation, family support and sexual counselling. Positive life enforcement can go a long way in keeping the person from returning to the old ways. They need constructive engagements such that it is easier to deal with free time without alcohol, develop a non-drinking social circle, and handle stresses on the job and at home without alcohol. Whether the treatment begins in an inpatient or an outpatient setting, the patient needs to stay in touch with the treating physician for at least six months.

Self help groups, such as Alcoholics Anonymous (AA), established in the US in 1935 and now with branches all over the world, offer continuing support and help in abstinence from alcohol, managing any relapses and begin life anew. The organization functions through local groups that have no constitutions, officers, or fees. Anyone who has a drinking problem may become a member.

A large number of alcoholics are able to win the battle. The path to success is self-determination.

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