Alcohol Abuse - Recognizing the danger signals of problem drinking

The chronic alcohol abuser shows physical symptoms that a physician can recognize. Among them are hand tremors, deterioration of eye functions, reduced bladder control, liver disorders, anemia, memory lapses, and others. But there are many other symptoms that family members and friends can observe, among them these:

1. • Alcohol use as a way of handling problems or escaping from them
2. • Increased use of alcohol with repeated occasions of unintended intoxication
3. • Sneaking drinks or gulping them rapidly in quick succession
4. • Irritation, hostility, and lying when the subject of alcohol abuse is mentioned
5. • A noticeable deterioration in appearance, health, and social behavior
6. • Persistent drinking in spite of such symptoms as headaches, loss of appetite, sleeplessness, and stomach trouble

Treatment

Methods of treating alcohol abuse fall generally into three categories. Choice of any one form of treatment depends on the particular needs of a client, including the degree of dependency. The three categories include the hospital, the intermediate, and the outpatient settings. Other approaches to treatment may be geared to individual or group needs.

The family physician can in most cases provide guidance on what kind of treatment would most benefit a particular patient. The alcohol abuser may be referred first to a toxicologist for an interview and recommendations on treatment. A review of the patient's history is a typical first step in treatment. Family involvement during therapy may be critically important. More than 4,200 centers offer treatment programs; of these, many are nonprofit clinics while others are units owned by for-profit health care chains. Many centers and clinics specialize in team approaches to therapy.

The Hospital Setting

Whether undertaken voluntarily or involuntarily (for example, by court order) the treatment formats offered in a hospital can be individualized.

Where some patients adjust best to inpatient care, others prefer partial hospitalization. In the latter case the patient is allowed to go home or to work at appropriate times, otherwise living in the hospital. In a hospital detoxification program, one designed to end physical addiction, the patient has a variable period, usually two weeks to a month, during which he or she undergoes a programmed regimen of activities. These may range from exercise classes to medications to bed rest and regulated diets.

The Intermediate Setting

The intermediate settings usually include at least halfway houses, quarterway houses, and residential care sites. The first of these offer not only living quarters but also job counseling, psychotherapy, and other services. In quarterway houses, the patient receives more attention in the form of counseling and psychotherapy. Residential care centers usually offer little beyond living quarters.

The Outpatient Setting

Again in the outpatient setting the patient has a range of treatment choices. Among them typically are individual counseling sessions held by a paraprofessional; individual therapy sessions with a professional who may have an advanced degree in social work, psychology, medicine, or a related specialty; and group therapy sessions supervised by either a paraprofessional or a professional.

Chemical Treatments

Some treatment programs utilize medications to help patients to “shake the habit.” Tranquilizers may be used to reduce tensions and prepare the patient for a follow-up stage. In a program of aversion therapy a substance called emetine may be prescribed. Taken before an alcoholic drink, emetine causes nausea. The treatment should be undertaken only under medical supervision.