Treatment of alcoholism. Prohibitive methods of treating alcoholism

Catad_tema Alcohol addiction - articles

Alcoholism and modern methods of its treatment

Yu.P.Sivolap
Department of Psychiatry and Medical Psychology MALA named after. I.M.Sechenova

The adverse health and social consequences of alcohol abuse are a serious problem modern society. Alcohol abuse is one of the most significant causes of increased mortality, as well as morbidity and decreased ability to work.

The results of more than 80 studies show a link between average per capita alcohol consumption and mortality in the population.

In the United States, alcohol-related deaths account for approximately 5% of overall mortality. In the Russian Federation, this figure is significantly higher: according to A.V. Nemtsov (2007), up to 29% of male and up to 17% of female mortality is in one way or another related to alcohol consumption.

The list of major alcohol-associated visceral lesions includes the following diseases:

Alcoholic cirrhosis of the liver
alcoholic pancreatitis
damage to the heart and blood vessels (including cardiac arrhythmias, ischemic disease heart, alcoholic cardiomyopathy)
gastrointestinal bleeding

In addition to the listed internal diseases, alcohol abuse leads to damage to the nervous system, manifested by numerous neurological and mental disorders(see below).

An increase in population mortality, visceral, neurological and mental disorders associated with alcohol abuse, and a decrease in labor resources that develops as a result of drunkenness turn alcoholism into one of the most expensive diseases for modern society. In the United States, annual economic losses caused by alcohol abuse and alcoholism reach $185 billion. .

Epidemiological data

Alcohol, along with caffeine and nicotine, belongs to the “legal triad” of psychoactive substances (PAS), the use of which (under certain conditions) age restrictions for the purchase of alcoholic beverages and tobacco products) is not punishable by law in European countries.

Unlike prohibited surfactants, many consumers do not associate alcohol with a health hazard. At least 95% of residents of Russia, Europe and the United States drink alcoholic beverages at least sometimes in varying quantities.

Alcoholism is the most frequent form dependence on psychoactive substances, requiring medical attention and causing a visit to a doctor.

Obtaining accurate data on the prevalence of alcoholism in the population is impossible due to the lack of methods for its reliable assessment. According to a number of experts, the proportion of alcoholics in developed countries ranges from 5-12% and is estimated on average at 10%. In Asian and African countries this figure is significantly lower.

Diagnostic criteria

Alcohol abuse, even if there are dangerous medical and social consequences, cannot be considered alcoholism in the absence of signs alcohol addiction, including mental and physical components.

In accordance with accepted international standards, the diagnosis of alcohol dependence is currently made on the basis of a statement of a set of formalized criteria provided for by ICD-10 and (in North American countries) DSM-IV.

In accordance with the DSM-IV criteria, to qualify as addiction or dependence on psychoactive substances, including alcohol, it is necessary to state at least three of the following symptoms: 1) tolerance; 2) withdrawal syndrome; 3) persistent desire or unsuccessful attempts to reduce substance use; 4) use of substances in larger quantities than initially expected; 5) violations of social and professional activities, as well as activities aimed at recreation and entertainment; 6) spending a large amount of time required to obtain substances; 7) continued use of substances, despite the problems arising as a result of this use.

We consider the following basic phenomena to be a necessary and sufficient condition for diagnosing alcohol dependence as the basis of alcoholism: 1) alcohol occupies an inappropriately high place in the hierarchy of an individual’s values; 2) the quantities of alcoholic beverages consumed always or in most cases exceed the expected or planned values (loss of control over the dose of alcohol); 3) alcohol consumption continues despite emerging obstacles, opposition from the environment, and the professional and social interests of the individual; 4) alcohol consumption is accompanied by the development of withdrawal syndrome.

The first three criteria reflect the mental component of alcohol dependence, and the last reflects its physical component.
The mental and physical components of alcohol dependence are not equal in terms of their danger and influence on the dynamics and outcome of the disease.
Alcohol tolerance physical dependence The withdrawal syndrome, as the main reflection of physical dependence, does not differ from it in consistency. Their presence and severity are determined by the phase states of the disease. During a period of stable abstinence from alcohol, physical dependence disappears.

Mental dependence on alcohol forms earlier than physical dependence and, unlike it, does not disappear even during remission. Exactly mental dependence from alcohol (or any other surfactant) explains the tendency to alcoholism (or any other addictive 1 disease) to an unfavorable course.

Gender characteristics

Alcoholism develops in women 3-5 times less often than in men. However, according to some data, in recent years there has been a tendency towards a decrease in the difference in male and female morbidity. In particular, it is indicated that if in previous years among schoolchildren and students alcohol abuse was more common among boys than among girls, now these indicators are equalized, and in certain youth subpopulations, drinking girls outnumber drinking boys.

In the non-medical environment, there is a strong idea, shared by some specialists, about the malignant nature and practical incurability of female alcoholism. Other experts (including A.Yu. Egorov and LKShaidukova, 2005) critically evaluate this idea, attributing the opinion about the malignant course of female alcoholism due to stigmatization drinking women.

In our opinion, the idea of the malignant nature and incurability of female alcoholism belongs to the category of clinical myths, but at the same time it cannot be denied that in women this disease proceeds in many ways differently than in men.

Alcohol dependence develops later in women than in men, but is characterized by more rapid progression. Women apply for medical assistance and demonstrate higher adherence to treatment with slightly worse results.

In accordance with our own observations, alcohol abuse and alcohol dependence in women are much more likely to be based on obvious psychological problems than men. Finally, premorbid borderline mental disorders in women who drink are detected twice as often (60-70%) as in drinking men (30%) .

Alcohol and the nervous system

Systematic or rare, but massive alcohol abuse in all cases without exception leads to damage to the central nervous system (CNS). Along with damage to the central nervous system, damage to peripheral nerves develops (alcoholic polyneuropathy).

Alcohol damage to the central nervous system is characterized by pronounced clinical diversity, which apparently reflects the complexity of the pathogenetic mechanisms underlying alcohol-induced pathological cerebral processes, as well as significant variability in individual types of reactions to alcohol intoxication and associated metabolic disorders.

Modern research shows that alcoholic damage to the central nervous system is based on three main pathogenetic factors:

Nutritional (caused by malnutrition) deficiency of thiamine (vitamin B1)
decrease in gamma-aminobutyric acid (GABA) content in brain tissue
excitotoxic 2 effects of glutamate

The latter mechanism plays a key role in the development of acute alcohol use disorders and alcoholic cerebral atrophy.

Alcohol abuse leads to increased synthesis of NMDA receptors, the natural ligand of which is glutamate. Alcohol withdrawal syndrome is accompanied by a massive release of glutamate from its connection with receptors and a damaging effect on brain structures. With a relatively favorable course of this process, the effect of glutamate on nervous tissue is of the nature of “biochemical damage,” and in more severe cases, glutamate causes neurodegenerative changes.

Glutamatergic mechanisms play a universal role not only in the formation of alcoholic encephalopathy, but also in the development of other types of cerebral atrophy, including Alzheimer's disease. The antagonistic effect on NMDA receptors and the resulting antiglutamatergic properties explain the effectiveness of memantine in the treatment of both dementia and, as some studies and our own experience show, in the treatment of acute alcoholic encephalopathy.

Alcohol damage to the central nervous system includes numerous psychopathological and neurological symptoms.

In our opinion, from the point of view of pathogenesis, alcoholic cerebral disorders can be divided into typical forms, in the development of which the main role is played by the pathogenetic factors described above (and the neurometabolic changes caused by them), and atypical

forms, the genesis of which is largely determined by hereditary predisposition (which is manifested by the presence of mental disorders of the schizophrenic and paranoid spectrum in relatives of patients with alcoholism) and the characteristics of the premorbid constitution.

Typical forms of alcoholic damage to the central nervous system include the following states:

Alcohol withdrawal syndrome
hangover seizures (alcoholic epilepsy)
typical variants of delirium tremens
Wernicke encephalopathy
Korsakov's psychosis
alcoholic dementia
moderate and mild (subclinical) manifestations of cognitive dysfunction

Atypical forms of alcoholic damage to the central nervous system

presented by the following list:

Atypical (endoform) variants of delirium tremens (including oneiric and paranoid delirium described by a number of authors)
alcoholic paranoid
acute and chronic alcoholic hallucinosis
alcoholic delirium of jealousy

Division of alcoholic damage to the central nervous system into typical and atypical forms is by no means only of academic interest. Typical variants of alcoholic cerebral disorders have the following fundamental differences from atypical forms:

Higher proportion of neurological symptoms in general structure painful manifestations (for example, neurological disorders in the structure of Wernicke encephalopathy have a significant predominance over psychopathological symptoms, and alcoholic epilepsy, in principle, is a purely neurological phenomenon)
higher incidence and severity of cognitive dysfunction
pronounced somatic aggravation of acute psychopathological syndromes
high mortality (can reach 8% in delirium delirium and 40% in Wernicke encephalopathy) The noted differences in the course and prognosis suggest fundamental differences in treatment tactics.

Typical forms often require intensive therapy, and in some cases resuscitation approaches, and the goals of treatment are correction of neurometabolic changes and support of vital functions.

Treatment of atypical disorders, the main expression of which is endoform psychopathological symptoms, may not have any fundamental differences from the treatment of schizophrenia or paranoid syndromes, and the main means of their treatment are antipsychotics.

Treatment approaches

Treatment of alcoholism includes two main stages: 1) relief of acute alcohol disorders; 2) anti-relapse therapy.

Relief of acute alcohol disorders V

primarily includes the prevention or elimination of withdrawal syndrome and its complications - hangover seizures and alcoholic delirium.

The first choice drugs in the treatment of alcohol withdrawal syndrome and its complications are the closest analogues of ethanol, the pharmacological effects of which are due to GABAergic activity - benzodiazepine derivatives. From the group of benzodiazepines, diazepam (Relium), chlordiazepoxide (Elenium) and, with slightly less effectiveness, lorazepam (Lorafen) are primarily used in the treatment of acute alcohol disorders.

To eliminate symptoms of alcohol withdrawal and prevent its complications, benzodiazepines are prescribed in fairly high initial doses.

The principle of high initial doses is not always observed in Russian drug treatment practice, which may be explained by doctors’ concerns about the possible risk of developing side effects. However, clinical practice shows that high doses of benzodiazepines prescribed during acute alcohol withdrawal usually do not pose a significant risk to the health of patients, while the ability of these drugs to eliminate acute withdrawal states and, in many cases, prevent the development of convulsive seizures and delirium tremens does not cause doubts. In those unfavorable cases of complicated alcoholism, when the development of alcoholic psychosis is impossible, timely prescribed benzodiazepines (as well as other means of rational therapy discussed below) can mitigate the course of psychosis and improve its outcome, including, most importantly, increasing the survival rate of patients alcoholism.

Intravenous diazepam should be considered a risky treatment approach. Individuals who abuse alcohol often demonstrate increased sensitivity respiratory centers brain to the respiratory suppressive effect of the drug, and intravenous injection diazepam may cause respiratory arrest. It is also important to take into account that the bioavailability of diazepam when administered intramuscularly is relatively low, which is explained by the peculiarities of absorption of the substance at the physiological pH values of skeletal muscles. Thus, intravenous administration of diazepam is risky, and intramuscular administration is not effective enough. However, it should be noted that diazepam, prescribed in sufficient doses, in most cases quickly and effectively eliminates acute manifestations alcohol withdrawal syndrome and parenteral administration of the drug, therefore, there is no clinical need.

For effective elimination symptoms of alcohol withdrawal and prevention of the development of delirium, diazepam is prescribed in a dose of 10-20 mg, chlordiazepoxide in a dose of 30-60 mg and lorafen in a dose of 2-4 mg. After 1 hour, if there is no desired effect, the drugs are re-prescribed.

Dosages required for maintenance treatment of alcohol withdrawal syndrome or alcoholic delirium are given in table.

Along with benzodiazepines, other GABAergic drugs are used in the alcoholism clinic, namely barbiturates and anticonvulsants- carbamazepine (Finlepsin) and valproate (Depakine).

Along with carbamazepine and valproate, in recent years more and more wide application V clinical practice new anticonvulsants are being found - lamotrigine (Convulsan) and topiramate (Maxitopir). A study of the results of therapy for 125 patients with alcoholism, conducted by E.M. Krupitsky et al. (2009), showed that lamotrigine and, to a slightly lesser extent, topiramate are comparable to diazepam and superior to memantine in their ability to eliminate acute symptoms of alcohol withdrawal.

It should be added to the above data that, unlike diazepam and other benzodiazepines, lamotrigine and topiramate do not cause excessive sedation and do not reduce cognitive function. Moreover, the antiglutamatergic properties of lamotrigine and topiramate suggest an improvement in cognitive functioning similar to (but apparently to a much greater extent) observed with the treatment of cognitive disorders with memantine.

Discovered by E.M. Krupitsky et al. (2009) the properties of lamotrigine and topiramate are classified as off-label effects and do not yet allow these drugs to be considered as an absolute alternative to benzodiazepines in the treatment of acute alcohol disorders, however, further studies confirming their safety and effectiveness may very likely serve as the basis for revision of existing treatment standards.

It must be emphasized that GABAergic drugs (and, with some reservations, glutamate antagonists) are characterized by pathogenetically directed effects and are therefore considered as the preferred means of treating acute alcohol disorders. The use of antipsychotics as alternative medicines for the same purpose is unacceptable for three main reasons: 1) antipsychotics lack the ability to influence the pathogenetic mechanisms underlying alcohol withdrawal syndrome and its complications, and therefore have only an indirect and weak effect on these conditions; 2) neuroleptics increase convulsive readiness, worsen neurological functions and exhibit many other side effects that worsen the condition of patients with alcoholism.

A necessary component of the treatment of acute alcohol use disorders and prevention (or treatment) acute forms alcoholic encephalopathy is the normalization of biochemical processes in the brain with the help of vitamins. Patients are prescribed thiamine (vitamin B 1) and secondarily other vitamins, including pyridoxine (vitamin B 6), cyanocobalamin (vitamin B 12) and nicotinic acid(vitamin PP).

Medical daily dose thiamine is 100 mg. In neurologically aggravated cases, as well as with Wernicke encephalopathy (or with the threat of its development), the required daily dose of thiamine is increased to 300500 mg.

In addition to the listed therapeutic measures, therapy for acute alcohol disorders includes intravenous drip infusion, the goals of which are rehydration and recovery. electrolyte balance(replenishment of deficiency of potassium and magnesium ions).

Among the various types of infusion drugs, electrolyte (crystalloid) solutions have optimal characteristics. There is usually no clinical need for the use of polyvinylpyrrolidone (hemodeza) and glucose solutions (except in relatively infrequent cases of hypoglycemia). Moreover, the administration of glucose (as well as any other carbohydrates) requires increased doses of thiamine, the deficiency of which in patients with alcoholism is, as mentioned above, a typical phenomenon. In cases where infusion therapy with the help of glucose preparations is still prescribed to patients with alcoholism, this curative measure should be preceded by parenteral administration of thiamine.

Effective treatment of alcohol withdrawal syndrome requires adherence to three basic principles: 1) urgent nature of therapy; 2) pathogenetic rationale in the choice of medicines; 3) optimal sequence of treatment measures.

If the first two principles usually do not raise questions, then the last one, in our opinion, requires special comment.

A typical medical error is prescribing infusion therapy without first taking benzodiazepines or other GABAergic drugs. medicinal products. Unlike the latter, infusion therapy per se does not have any effect on alcohol withdrawal syndrome, and the administration of glucose solutions without appropriate correction with thiamine can, if there is a predisposition, directly provoke the development of Wernicke encephalopathy.

The main goal of anti-relapse therapy for alcoholism is stable remission of the disease. In cases where patients with alcoholism, despite the treatment, are not able to completely stop drinking alcohol and the designated goal turns out to be unattainable, therapy is supportive in nature, and its goal is to improve the course of the disease, namely to reduce the frequency and severity of alcoholic excesses and prevent binge drinking and mitigating the adverse consequences of alcohol abuse.

Anti-relapse (maintenance) therapy for alcoholism in most developed countries it is carried out using three main drugs: disulfiram, naltrexone and acamprosate.

Disulfiram is a classic means of aversive treatment of alcoholism. The pharmacological activity of disulfiram is based on the irreversible inhibition of the activity of acetaldehyde dehydrogenase, an enzyme that catalyzes the conversion of acetaldehyde to acetate (acetic acid). The accumulation of acetaldehyde in the body under the influence of disulfiram when drinking alcohol leads to the development of “acetaldehyde syndrome”, or disulfiramalcohol reaction (DAR).

DAR is characterized by the following clinical manifestations:

Increased blood pressure
tachycardia
heartbeat
throbbing pain in the head
blurred vision
nausea and vomiting
shortness of breath and feeling of lack of air

The most a clear symptom DAR is the redness of the skin, and the main manifestation of the aversive effect of disulfiram and its most useful therapeutic effect is the fear of death, which, in the case of successful therapy, forces the alcoholic patient to stop drinking alcohol.

The initial (during the first 5 days) daily dose of disulfiram is usually 800 mg. For further maintenance therapy, it is recommended to take disulfiram at a daily dose of 400 mg, usually 200 mg 2 times a day. In some cases, the drug is prescribed at a dose of 800 mg every other day (or 3 times a week).

The duration of aversive disulfiram therapy is usually determined by clinical need. In some cases, it is advisable to use short courses in situations that can provoke another alcoholic excess.

Unfortunately, despite the use of any therapeutic approaches, the treatment of alcoholism is characterized by low effectiveness, which is determined by a number of reasons, including poor motivation of patients for treatment and, consequently, their insufficient desire (compliance) to follow medical recommendations. In accordance with the opinion of some experts (the validity of which is confirmed by our own clinical observations), compliance during treatment with disulfiram and, consequently, the effectiveness of therapy can increase significantly when relatives, primarily spouses of alcoholics, monitor the drug intake.

An innovative and very successful dosage form of disulfiram, in our opinion, is water-soluble (“effervescent”) tablets produced by the Actavis company under the classic name “Antabuse”.

The solubility of Antabuse in water in the absence of taste and odor allows the patient's relatives (in the absence of the risk of serious complications of DAR) to add the drug to food or drink in cases of potential effectiveness of therapy if the patient refuses treatment.

Thus, each intake of a soluble tablet, unlike a regular one, will ensure a reliable supply of the drug to the patient’s body.

In addition, the rapid release of the drug into the blood, provided by this dosage form, implies the timely development of a clinical effect, which can be of absolute importance in the practice of treating alcoholism.

Antabuse tablets are available in two forms, 200 and 400 mg, which corresponds to the doses noted above recommended for maintenance therapy.

Apparently, many practical narcologists are familiar with a phenomenon that can be defined as the “sinusoid effect” and which reflects fluctuations in the effectiveness of treating alcoholism (and, probably, some other diseases) with the help of different medications. The emergence of a new drug is usually accompanied by an increase in the effectiveness of treatment, including due to the unique placebo component of its action. Then, after the inevitable accumulation of cases of unsuccessful therapy and the formation of a more negative image of the drug or treatment method among patients and their relatives, the effectiveness of treatment decreases, in order to increase again after a few years with increasing interest in the less frequently prescribed and therefore “forgotten” drug. The dynamics of popularity and, to a certain extent, indirect psychological factors The clinical effectiveness of drugs thus acquires the character of a sinusoid. According to our observations, the popularity and therefore the potential clinical effectiveness aversive therapy for alcoholism is currently experiencing another rise, and the emergence of a new form of disulfiram in the form soluble tablets, of course, can significantly expand the capabilities of practitioners in anti-relapse (maintenance) treatment of alcohol dependence.

Along with pharmacological therapy, psychotherapy and other non-drug approaches are used in the treatment of alcoholism. In accordance with WHO treatment standards, cognitive and behavioral psychotherapy is considered the optimal psychotherapeutic approaches in treatment (as well as other addictive diseases).

It should be noted that the combination of psychotherapy and pharmacological therapy for alcoholism can increase the effectiveness of the latter due to more successful implementation of its potential.

1 From English addiction
2 From English excitement “excitement” and toxic “toxic”.

Literature

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Alcoholism remains one of the most important medical and social problems. Much attention is paid to research into the clinical picture and dynamics of this common disease and further improvement of therapeutic and preventive programs.

It is known that chronic alcohol intoxication leads to disruption of cerebral metabolism; chronic alcohol abuse is associated with deterioration of intellectual and mnestic functions. According to many authors, both foreign and domestic, the deterioration of higher mental functions is associated both with the direct toxic effect of alcohol on the brain and with an indirect mechanism due to liver damage. In addition, one should take into account not only the toxic effect of alcohol and the consequences of acquired liver pathology, but also disorders associated with the psychophysiological mechanisms of dependence on psychoactive substances. Intellectual-mnestic decline in patients with chronic alcoholism is considered within the framework of alcoholic personality changes that develop at distant stages of the disease. “Alcohol degradation” includes affective disorders, psychopathic-like symptoms, ethical decline, loss of a critical attitude towards alcohol abuse and one’s condition in general, persistent changes in memory and intelligence.

A rather difficult problem in terms of choosing therapeutic tactics is complicated forms of withdrawal syndrome. For example, withdrawal syndrome with reversible psychoorganic disorders is clinically expressed by mnestic disturbances, a decrease or complete loss of criticism of one’s own state and the environment, weakness, euphoria, irritability, even unmotivated anger. Patients are unable to clearly formulate their thoughts, get stuck on unimportant details, and have speech that is poor in words. As a rule, neurological symptoms occur: dizziness, ataxia, generalized tremor, dysarthria, anisoreflexia, pupillary and oculomotor disorders, nystagmus, extrapyramidal signs.

In connection with the above, it is especially important both in the acute period and in the subsequent period to prescribe rational complex therapy that can correct the listed disorders. In the complex treatment of alcoholism, along with specific anti-alcohol drugs, it becomes necessary to use drugs aimed at reducing changes in tissue metabolism, which ensures more stable results. Currently, drugs with nootropic activity (piracetam, gammalon, aminalon, picamilon, etc.) are widely used.

Nootropics are indicated for patients not only in withdrawal syndrome in order to prevent the development of complications, but also in advanced (2nd or 3rd) stages of the disease, when clear signs of alcohol degradation and intellectual-mnestic decline are detected. At the stage of remission formation, neurometabolic drugs are prescribed to restore the body’s adaptive resources, reduce pathological craving for alcohol and prevent early relapses. An indication for the prescription of nootropic drugs is also the presence in the clinical picture of affective disorders with an adynamic component, exhaustion, general loss of activity; one of the most important indications is the threat of developing alcoholic psychoses. The search for new neurometabolic drugs that are more effective in treating alcoholism continues.

One of these drugs is instenon. Instenon is combination drug, it consists of three active components - hexobendine, etamivan and etophylline. Their effect is synergistic on various parts of the pathogenesis of ischemic and hypoxic damage to the nervous system. Hexobendine selectively stimulates metabolism in the brain. The neurometabolic mechanism is due to an increase in the utilization of glucose and oxygen due to the transition to anaerobic glycolysis and activation of pentose cycles. Stimulation of anaerobic oxidation, in turn, potentiates the formation of compensatory synaptic connections to replace lost ones. Improving neuronal metabolism leads to improved cerebral and cardiac circulation. Etamivan activates all functions of the brain, affects vegetative formations at the suprasegmental level (primarily the limbic-hypothalamic-reticular complex), normalizes the adaptive systems of the body, regulates blood circulation, breathing, and maintains homeostasis. Etophylline has a positive effect on myocardial metabolism. All these properties of the drug allow it to be widely used in neurological and psychiatric practice for vascular diseases of the brain, psychoorganic syndrome within various mental illnesses, and depressive manifestations in involutionary age.

In 2002, at the Research Institute of Narcology of the Ministry of Health of the Russian Federation, a study was conducted on the use of the drug instenon for chronic alcoholism.

Conducted clinical trial allowed us to draw the following conclusions. Instenon turned out to be a very effective drug for the treatment of patients with chronic alcoholism. In case of alcohol withdrawal syndrome, its sufficient therapeutic effectiveness has been revealed in relation to such psychopathological manifestations as lethargy, weakness, apathy, and anxiety. The effect on dysphoric symptoms can be assessed as moderate or mild. The drug also has a pronounced vegetative-stabilizing effect, which manifests itself already on the 3-4th day of its use.

In the post-withdrawal state, its significant nootropic activity becomes obvious; when using the drug for 3-4 weeks, memory and concentration significantly improved, performance and general adaptive capabilities of the body increased.

Separately, it should be noted that instenon had a fairly good effect and quickly stopped the manifestations of the asthenic and asthenodepressive symptom complex.

The positive properties of the drug include the lack of expression of the activating effect.

The most positive therapeutic results with the use of intenon were observed in patients with stages 2-3 and 3 of alcoholism with symptoms of alcohol degradation and alcoholic encephalopathy.

When using instenon, side effects of the autonomic register (increased blood pressure, tachycardia, tachypnea) were observed only in the first days of its parenteral administration, which resolved independently with continued therapy without additional drug correction. When using tablet forms, side effects were minimal and no complications were observed.

The results obtained are of great importance for the treatment of patients with alcohol dependence and allow us to recommend the inclusion of instenon as quite effective and safe drug into comprehensive therapeutic programs.

Drug treatments

Drug treatment of alcoholism involves the use of pharmaceuticals that cause a person’s aversion or indifference to alcohol. An alcoholic must be treated strictly with his consent and after a full examination. During therapy, the patient must be under constant medical supervision.

By the way, drugs for alcoholism can also be used at home. However, most of them are available only with a prescription from a doctor. That's why anti-alcohol drugs can only be used after consulting a specialist. Under no circumstances should you mix them into the food or drink of an alcoholic without his knowledge. This is prohibited by law and extremely dangerous to human health and life.

This technique is one of the most effective remedies against ethanol addiction. Its essence lies in the formation of a persistent aversion to alcoholic beverages in the drinker. To do this, he is given disulfiram-containing drugs that cause intolerance to alcohol. As a result, a person becomes ill from just the taste or even the smell of alcohol.

Disulfiram-based drugs act on liver enzyme systems, disrupting metabolism (cleavage) ethyl alcohol. Because of this, human blood accumulates a large number of acetaldehyde, which causes sharp deterioration well-being. People experience high blood pressure, headaches, nausea and vomiting. Similar effects occur only after drinking alcohol.

The following drugs are used for coding:

Teturam;
Esperal;
Antabuse;
Disulfiram;
Tetlong-250.

Disulfiram-containing drugs have a variety of release forms. On pharmaceutical market they can be found in the form of tablets, injections and implants for suturing. The tablets can be taken at home, but disulfiram-ethanol tests should only be performed under the supervision of a doctor. Injections or suturing of implants can only be done in a specialized medical facility.

Fact! Long lasting stitching or intramuscular injection is a consequence of the gradual release of disulfiram. The substance gradually leaves the depot, preventing the alcoholic from drinking alcohol. This helps a person quit drinking and wean himself off alcohol for a long time.

Blocking opioid receptors

Any person drinks alcoholic beverages for pleasure. Once in the blood, alcohol spreads throughout the body, crosses the blood-brain barrier and enters the brain. There it binds to opioid receptors and stimulates them. It is because of this that the alcoholic experiences euphoria.

If these receptors are blocked, they will become insensitive to alcohol. This can be done with drugs such as Naltrexone and Vivitrol. The action of opioid receptor blockers is aimed at suppressing the pleasure of drinking alcohol. Not receiving pleasant sensations, the alcoholic will no longer see the point in further drinking. Thus, blockade of opioid receptors helps to quit drinking completely painlessly.

Psychological methods of combating alcoholism

Psychotherapeutic treatment of alcohol addiction consists of purposefully influencing a person’s subconscious in order to induce in him an aversion to alcohol. Today, coding with hypnosis and psychotherapy is no less popular than the use of medications. Unfortunately, it has one huge drawback - high risk get an appointment with a charlatan or a bad specialist.

Treatment of alcoholism with hypnosis is quite effective, but it is not suitable for all people. If a person does not want to be treated or does not believe in his recovery, most likely this method It won't help him. Hypnosis for alcoholism should only be used when the alcoholic is susceptible to it and sincerely wants to stop drinking.

Treatment of alcoholism with hypnosis involves putting the patient into a trance state and influencing his subconscious. The hypnotist instills in the alcoholic an aversion to alcohol, its taste and smell. After the session, it becomes unpleasant for a person to even think about alcohol. Coding for alcoholism using hypnosis can be carried out both in a medical facility and at home. Many clinics offer home visits by a specialist, which is very convenient for people who do not want to advertise their illness.

Quite often along with medication coding Psychological assistance is used for alcoholism. Qualified psychologists work with sick people. They help recent alcoholics return to a sober lifestyle and learn to behave in society and family. Psychologist help with alcoholism is provided both individually and in the form of group sessions.

Many drunkards are embarrassed or do not consider it necessary to attend the so-called “alcoholics anonymous societies.” But in vain, because they often really need such support. People who have recently returned to a sober lifestyle find it extremely difficult to integrate into society and find some interests and hobbies. Psychological assistance for alcoholics helps them adapt faster and significantly reduces the risk of relapse (return to drinking).

Dovzhenko method

Exist different kinds psychotherapeutic coding, but the Dovzhenko method is considered the most popular and effective. It allows you to cure even severe addiction. This psychotherapy for alcoholism does not require immersion in a deep trance - during the session the person is conscious.

Dovzhenko's method works even on people who cannot be hypnotized. The only thing, but extremely important condition successful coding - sincere and desire stop drinking. If the alcoholic does not want this, treating him using this method is pointless.

Shichko method

This technique is used exclusively for independent recovery from alcoholism. It is a step-by-step program that an alcoholic must carry out on his own, without anyone’s help. Shichko's method is more effective in the initial stages of alcoholism, when a person is still able to control his own actions.

Like psychotherapy for alcoholism, this technique helps a person realize the dangers of drunkenness. Step by step closer to recovery, he feels better. Gradually, the former alcoholic stops depending on alcohol, finds new hobbies and returns to a sober lifestyle.

Advice! Treatment of alcoholism with hypnosis and the methods of Shichko and Dovzhenko should be used extremely carefully. They are effective only for individuals with high hypnotizability (sensitivity to suggestion).

Laser coding is one of the most modern methods of treating many types of addiction. It is also great for getting rid of alcoholism. Laser treatment is not yet very popular today, but is available in many modern clinics. With its help, many people have already managed to quit drinking.

Laser radiation affects active points human body, specifically associated with certain areas of the brain. This inhibits alcohol addiction centers located specifically in these areas. Thanks to laser coding, a person’s craving for alcohol and the desire to drink it disappear.

Contraindications to laser treatment:

mental disorders, traumatic brain injuries;
damage to the nervous system of an infectious, inflammatory, traumatic nature;
any malignant neoplasms;
decompensated heart and vascular diseases.

Laser coding can cause the following side effects:

lethargy, apathy, lack of initiative;
frequent and causeless mood swings;
aggressiveness and temper;
loss of appetite and dyspepsia;
anxiety, insomnia, depression;
decreased potency and even temporary impotence.

As a rule, all consequences of laser coding are harmless and go away on their own. The risk of their occurrence largely depends on psychological state person and the degree of his dependence. In most cases, all symptoms completely disappear within several months or six months.

Treatment of alcoholism with acupuncture

Acupuncture (this Eastern technique is also called acupuncture) belongs to the alternative methods of treating alcohol addiction. During the session, the specialist uses needles on special acupuncture points on the patient’s body, responsible for the craving for alcohol. To avoid unnecessary injury to a person, the doctor uses the most thin types needle

To stop drinking with the help of acupuncture, you need at least 10-14 sessions. Procedures should be performed 2-3 times a week for a month. They can be done both in the clinic and at home by inviting a specialist. As a rule, the doctor acts on points in the ear or back area. During the session, the alcoholic’s body begins to produce endorphins (hormones of happiness), which dull the craving for alcohol.

Acupuncture for alcoholism causes far fewer side effects than all types of drugs used for drug treatment. Moreover, after a course of acupuncture, a person’s blood circulation improves, the functioning of many organs is normalized, and almost all unpleasant symptoms disappear. The alcoholic's headaches and muscle cramps disappear, and his sleep and emotional state normalize.

Treatment of alcoholism with homeopathy

In addition to acupuncture, there are other non-traditional methods of treating alcoholism. Homeopathy is quite popular and effective – treating “like with like”. A person is given a medicine causing symptoms, similar to the symptoms of his illness. This allows you to stimulate the body and helps a person quit drinking faster. You can treat alcoholism with homeopathy yourself, at home, but before doing so it is better to consult a specialist. He will select the most suitable medical remedy and give useful recommendations.

Various homeopathic drops are widely used to combat alcohol addiction. Together with them, experts recommend using enterosorbents (Enterosgel, Smecta, Polyphepam). These remedies help relieve intoxication and promote the removal of harmful substances from the body.

Homeopathic drops to combat alcoholism:

Konium;
Nux-Vomica;
Nux-Vom plus;
Capsicum;
Acidum-S;
Hamomilla.

Almost all homeopathic drops are made from natural ingredients vegetable, mineral or animal origin. They extremely rarely cause allergies and are very well tolerated. Any homeopathic remedy causes fewer side effects than pharmaceutical drugs against alcoholism.

Important! Homeopathic drops can only be used with the consent of the person. Mixing them into food or drink without his knowledge is strictly prohibited. This is not only dangerous to health, but is also prohibited by current legislation. Drops are best used after consultation with the doctor and the alcoholic himself.

ethnoscience

Many people prefer to treat alcohol addiction at home, without seeking the help of a specialist. The use of traditional methods against alcoholism has both advantages and disadvantages. In addition, it is possible to treat a person without the help of doctors only in the initial stages of the disease.

To the benefits traditional medicine should include low cost, convenience and the use of exclusively natural medicines. People who are ashamed of their problem do not need to advertise it by turning to strangers for help. Therefore, relatives often prefer to treat an alcoholic at home. They prepare decoctions, infusions, drops or other remedies and give them to the drinking person.

Disadvantages of traditional medicine:

lack of a full examination and examination before starting therapy;
high probability of complications (many herbs used to combat alcoholism are quite toxic and can cause poisoning if used incorrectly);
high risk of relapse (return to drinking after a certain time).

In some cases, treating an alcoholic at home is extremely undesirable. For example, with prolonged binge drinking, severe withdrawal syndrome or alcoholic psychoses hospitalization is inevitable. In these situations, all attempts to treat a person on their own can lead to unpleasant consequences.

Folk remedies to combat alcoholism:

decoctions, drops, infusions of thyme, centaury, wormwood;
alcohol tinctures of bay leaves and lovage root;
drops, tinctures, decoctions from the root of the European hoofed grass;
crayfish shell powder;
bearberry drops and decoctions;
sour apples, honey, soda and others folk remedies.

Alcoholism in the world of modern medicine has long been recognized as a disease. Chronic, long-lasting and fatal. After all, this pathology completely erases a person’s entire personality and mercilessly destroys internal organs, forming on the physical and mental level. These problems are mainly solved by psychotherapists and narcologists, developing a course of therapy for addicts.

Medical specialists work to cleanse the body of the effects of ethanol, others “cleanse” the soul, returning the patient to social society. There are many methods for treating addiction, and new methods of treating alcoholism appear regularly. It will be interesting to find out what methods modern doctors use, what is new in the treatment of alcohol addiction.

For the treatment of alcohol addiction, many effective techniques

Everyone is familiar with the expression: “Everything new is well forgotten old.” True, modern doctors have not forgotten, but successfully continue to use time-tested methods of treating alcohol addiction. The first step you should take to recover is to visit a narcologist. But this is not enough.

The reason for addiction to alcohol lies far in the corners of a person’s subconscious. When ridding him of addiction, one cannot do without the coordinated work of a drug addiction specialist and a psychologist.

Effective treatment of alcoholism using conventional methods lies in the well-coordinated tandem of efforts of two medical representatives. The process consists of several steps.

There are three main directions in the treatment of alcoholism

Eliminating withdrawal symptoms

Doctors call withdrawal syndrome the state of the body that has become accustomed to the constant supply of alcohol and is forced, for some reason, to give up the usual doping. The absence of ethanol, which has already become a familiar addition to metabolic processes, causes a real shock in a person, accompanied by a painful malaise and an uncontrollable desire to pour into himself another portion of the strong drink.

Signs of withdrawal

It is at this moment that the addict vitally needs the help of narcologists, whose tasks include complete cleansing suffering body from alcohol metabolites and translation of work internal organs for normal “clean” functioning. For this they use whole line medical procedures, the main one of which is an IV.

Some patients decide to dig themselves out at home. But such an experiment is not approved by doctors.

At home there is no guarantee of complete isolation of a person’s access to alcohol, and the reactions of a poisoned body can be too unpredictable. Several cases of death have already been recorded when trying to carry out a home drip to withdraw from withdrawal symptoms. This procedure It is better to carry out in a clinic under the watchful eye of a doctor.

Reanimation of lost health

After removing all ethanol remnants from the exhausted body, a person needs to restore the internal organs crippled by alcohol and return them to healthy functioning. At this stage, specialists use a number of the following medications:

medications to manage residual withdrawal symptoms;
drugs for the treatment of alcohol-related mental disorders;
systemic drugs that work to suppress cravings for drinking.

Which medications can be used, their dosage and duration of use are determined by the attending physician. The specialist takes into account the condition of the addict and the presence of various additional chronic diseases. Such therapy is very long and sometimes drags on for years. The risk of relapse and return to drinking is also too great.

New methods of treating alcoholism

Modern medicine does not stand still. Innovations and innovative developments also concern therapeutic methods for treating alcohol addiction. New methods of therapy are varied, but they all have one goal - to cause and form in the patient an aversion to alcohol. This is what guarantees successful and long-term remission.

There is also compulsory treatment for alcoholism

All modern treatment regimens for alcohol addiction include the following measures:

Hemming.
Coding.
Hardware treatment.
Methods of psychotherapy.
Influence through hypnosis.
Unconventional methods of treatment.

Hemming

This method of therapy cannot be called completely new. But although it is already quite many years old, it is considered one of the most successful and effective. The essence of the treatment is the injection of a certain medication under the patient’s skin. The following binders are most often used in clinics:

Based on disulfiram. This medication is considered the main one for getting rid of alcohol addiction. This method works on the manifestation of painful symptoms immediately after ingesting another dose of alcohol: from an attack of angina pectoris to severe cerebral edema and death of a person.

The essence of hemming

Before the procedure is carried out, the addict is warned about the consequences of continued drinking and a receipt is taken from him.

For this reason, drugs with disulfiram are indeed one of the most effective and efficient in the treatment of alcoholism. More often, doctors use drugs such as:

Tetlong;
Teturam;
Algominal;
Chemical protection;
Tetlong-250;
Esperal.

Blocking the satisfaction center. These binders work by stopping the areas of the brain that are responsible for a person’s formation of the feeling of satisfaction that appears after drinking. The implant is sewn into the patient under local anesthesia; the entire procedure takes only half an hour.

Before undergoing it, a person undergoes a full course of cleansing the body of ethanol metabolites. The validity period of the binder is 5-6 months. This time is quite enough for recovery. The most commonly used means are:

Vivitrol;
Naltrexone.

Before the hemming procedure, a person will have to avoid touching alcohol for 3-7 days. The implant itself is inserted into the gluteal muscle or soft fabrics back areas. After the event, the patient will have to follow a regime limiting any physical activity for the first few days. For some time you should forget about water procedures.

The drugs themselves do not cause any harm to a person if he leads a sober lifestyle. But the process of holding an event for many people turns out to be painful and accompanied by inconvenience. According to reviews, the binder is especially effective in the first stages of alcohol dependence.

Coding

According to experts, this is the most effective method of treating alcoholism. Coding is inherently a stress-emotional method of psychotherapy. With its help, the patient’s subconscious is influenced and he develops a strict ban on drinking alcohol.

Coding is one of the effective ways to treat alcohol addiction

The founder of the anti-alcohol coding method is narcologist Alexander Dovzhenko. It was this specialist who developed effective technique influence on the subconscious of the individual.

The procedure itself is based on a normal conversation with the patient. During this process, the doctor suggests to the person, using an emotionally stressful manner of dialogue, what awaits the addict if he continues to drink alcohol. It is not for nothing that this method is considered one of the most effective - the vast majority of people actually successfully got rid of addiction after the procedure.

Dovzhenko coding has many advantages (compared to other treatment methods):

humanity;
anonymity;
safety for humans;
simplicity of the procedure;
high degree of effectiveness;
absence of various side effects;
Just one session is enough to get results.

No additional manipulations or medical interventions are used during this treatment. The person himself is fully conscious and aware of everything that is happening. Coding according to Dovzhenko forms in the patient a persistent negative reflex to alcohol without any unpleasant consequences for good health.

Hardware treatment

Using modern hardware methods for treating alcoholism, doctors influence the patient’s brain functions. Doctors use special devices. With help this method therapy for the patient:

brain function is normalized and reanimated;
the desire and need for alcohol is completely eliminated;
stops brain receptors responsible for addiction to alcohol and receiving pleasure and drinking.

The most well-known technology of this method of therapy for alcohol addiction is TES therapy. This electrical stimulation brain regions was created by the joint efforts of scientists from the Center for Transcranial Electrical Stimulation under the leadership of professor neurophysiologist Valery Pavlovich Lebedev.

Hardware treatment - an innovative method of treating alcoholism

This technique was based on advanced scientific developments and research. EFT therapy is successfully used in the treatment of alcohol addiction in 18 countries. But the innovative and effective method has a number of contraindications. The prohibition in this case becomes:

Brain tumors.
Severe brain injuries.
Diseases of the central nervous system of an infectious nature.
Severe skin injury in areas intended for application of electrodes.

Psychotherapy methods

The essence of psychotherapy in the treatment of alcoholism

Psychotherapeutic methods of treatment have long and successfully proven themselves in the treatment of alcohol addiction. This includes successful procedures such as:

Malkin's own method of therapy;
psychotherapeutic sessions using the Rozhnov method.

The essence of the methods is to influence a person with psychotherapeutic attitudes in order to develop the necessary emotional and volitional attitudes. To obtain a more effective and guaranteed result, family members of the patient also participate in treatment sessions.

Hypnosis

No less successful and effective way The treatment for alcohol addiction is hypnosis. During the session, the patient is instilled with complete indifference or aversion to any type of alcohol, and is given an orientation toward a sober, “clean” lifestyle. But unfortunately, this method is not suitable for everyone; many people are not amenable to attitudes (non-hypnotic).

Hypnosis is considered one of the most effective ways to treat alcohol addiction.

One of the peculiarities of hypnotherapy is the fact that a person must come to the procedure absolutely sober, otherwise the patient simply will not perceive the necessary information.

Unconventional methods of treatment

In addition to modern developments in the fight against alcohol addiction, various traditional medicine techniques are also successfully used. These methods cannot be called innovative, but their use helps restore and support the body during a difficult period of therapy. For these purposes, many are used medicinal herbs and plants that have a variety of effects on humans.

To reduce the desire to drink:

angelica;
sagebrush;
St. John's wort;
centaury;
creeping thyme.

Fees based on poisonous herbs to induce aversion to alcohol:

thyme;
dung mushroom;
club moss;
European hoof.

These plants are more radical in their effects. When using them, the patient (if he drinks alcohol) experiences a number of unpleasant symptoms(nausea, vomiting, headache, weakness). On the basis of such properties, an aversion to drunkenness is formed at a subconscious level.

Other treatments

Narcologists talking about unconventional ways alcohol addiction therapy, they also mention procedures such as meditation and acupuncture. These methods are based on complete physical relaxation of the patient. Freed from stress and surrounding problems, it is easier for a person to realize the main cause of his problem and find ways to remove it.

In addition, acupuncture also helps general strengthening weakened body, strengthening it protective functions, stabilization of the nervous system and immunity. Helps get rid of nervous tension and meditation. For the same purposes, a special breathing exercises, yoga. All these methods are successful as preparatory procedures for treating the first stages of alcohol addiction.

Methods of delivering a person from the worst evil huge variety. But the result depends entirely on the mood of the patient himself and his family members. First of all, the addict himself has to take a huge step towards full recovery - admit he has a problem and begin full-fledged treatment.

Alcoholism is a serious problem of our time, a common medical problem, and, finally, one of the the most difficult problems which requires psychological support. Eat different methods treatment of alcohol addiction, among which every person with this problem can find the most effective one for themselves. Let's get to know them better. But before you look for a therapeutic method, we suggest you take a short test to understand whether you really need treatment.

Drinking alcoholic beverages is practically normative behavior of a modern adult. When everyone around you is constantly drinking alcohol, it is difficult to understand how much you yourself are drinking. This short test will help determine the extent of your alcohol addiction.

Do you often need to drink to calm down (for example, after a quarrel or trouble)?
Have you ever drunk alone?
Do you feel the urge to drink when you're depressed?
Do you tell yourself that you need to drink less?
Do you notice that when you are in company you want to drink more than is normal?
Do you get bored in a company where there is no alcohol?
Do you want to add more when those around you have already stopped?
Do you feel guilty or want to hide the amount of alcohol you drink?
Do you minimize the amount you drink in front of your loved ones?
Have you ever felt ashamed of something you did or said while drunk?
Do you experience memory loss after drinking alcohol?
Do you have difficulty falling or staying asleep?

If you answered “Yes” to 3 or more questions, this means that your relationship with alcohol is becoming dangerous.

There is another simple way to check if you have alcoholism. Just tell yourself: "No more than 50-100 grams per day for 2 months, no matter what." If you relapse, it means that your levers of effective control are already loose and the time has come to look for effective methods and methods for treating an emerging alcohol addiction.

What do you need to know?

Alcohol addiction develops quite quickly long time, passing through several stages:

Struggle modern means and methods with alcohol dependence are most effective in the first and second stages, since the consequences of alcoholism in such patients are still reversible. But the treatment of alcohol addiction in the third stage is very long and difficult, and the rehabilitation period is greatly increased. Therefore, it is necessary to start fighting this disease as early as possible, while it is still easy to cope with.

Alcoholism can be treated either in a clinic or a special center or at home. At your request, such treatment can be carried out completely anonymously. The types and means that can be used to cure alcoholism today are pleasing in their diversity: these include drug therapy, folk remedies, and psychological support. In addition, more and more patients are deciding to treat their addiction using the coding method. Prevention of alcohol consumption is also important.

Help with abuse

Treatment of alcoholism – the whole complex psychological and medical measures that make it possible complete failure from alcohol and the person’s return to normal life. To begin to effectively treat this disease, doctors need to force the patient to voluntarily or forcibly completely stop drinking alcohol. This is necessary so that his body is cleansed of alcohol and its breakdown products. Then the patient begins to be treated with special medicines, and then a psychologist or psychotherapist joins the therapy, helping the person adapt to normal life. let's consider different variants medical and psychological support in the treatment of alcoholism.

Usually, in order to begin to treat alcoholism, you first need to get the person out of the binge. This event is carried out only by a narcologist. Self-medication or seeking help from persons without medical education can lead to the most dire consequences.

Recovery from binge drinking is carried out in 2 ways: a doctor comes to the house or the patient is admitted to a hospital. Although the price for these services can vary greatly (from 2,500 to 9,000 rubles), the second option is more preferable, since in the clinic the doctor can use various therapeutic and diagnostic tools, as well as constantly monitor the patient.

Getting rid of withdrawal symptoms

At abrupt refusal From alcohol, a person can develop withdrawal syndrome, or, as people say, “delirium tremens.” This condition is fraught with the most severe consequences, including the commission of criminal offenses or death. Withdrawal syndrome should be treated only inpatiently. The price of 1 day in a hospital will cost from 1500 to 10 thousand rubles. per day, depending on the severity of the syndrome, the prestige of the clinic and the amenities offered.

Detoxification

After withdrawal from binge drinking, alcohol must be completely removed from the body. Most often, this is done by administering special medications through an IV. In parallel with medications, modern methods and means of treating alcoholism are increasingly being used: bioxenic therapy (inhalation of a mixture of oxygen and xenon through a mask) and plasmapheresis (purification of blood plasma using special devices). These methods are considered the most effective means today, and the prices are quite affordable: from 6 thousand rubles.

Inhibitory therapy or coding

After detoxification, the patient may decide that it is okay to drink again, since now everything will be fine. To prevent relapse, coding is done immediately after detoxification.

To do this, the following prohibiting means are used:

Selection of the most effective remedy in each specific case it is always carried out individually by a narcologist.

Unlike psychological or neurophysiological coding, drug-assisted treatment methods should be used very carefully, as they are only safe for patients who are able to maintain absolute sobriety while they are being treated.

Inhibitory therapy and coding have long confirmed their high efficiency, they are successfully used all over the world. The disadvantage of any prohibitive therapy is that after the patient stops being treated, he may have a breakdown, so to consolidate the effect it is necessary a long period psychological rehabilitation. It should also be taken into account that psychological coding methods are highly dependent on the mental characteristics of the sick person, so it is important to find a highly qualified specialist.

Psychological assistance and rehabilitation

After it has been possible to relieve the acute manifestations of alcoholism, we use psychological impact and rehabilitation of the patient to new living conditions. These methods are aimed at creating a negative attitude towards drinking alcohol and stopping drinking alcohol.

This complex therapy is aimed at restoring the body of a person who has been drinking alcohol for a long time. Such treatment includes drugs that normalize the condition of internal organs, the cardiovascular and nervous systems. The most important role psychological assistance and support, as well as the prevention of repeated alcoholism, play a role. After all, if a former alcoholic is not confident in his own strengths and capabilities, he will definitely return to drinking alcohol.

Traditional methods

Traditional methods are based on the use of various natural ingredients. Most of these remedies are available at home. They usually contain honey and a variety of herbal infusions. There are other unconventional methods. Although this treatment will cost you less than traditional therapy, be sure to consult with your doctor before you begin treating a patient.

How to make a choice

Important issues for people wishing to treat alcoholism are the choice of clinic and the price of treatment. The average cost of treatment in Russia varies from 6 to 30 thousand rubles (depending on the chosen method). Moreover, the larger the city, the higher, as a rule, the price turns out to be. Thus, prices for coding in Moscow are 20-30% higher than similar services in the outback of Russia. Therefore, when choosing a clinic, you should not focus only on price: a high price is not always a guarantee of quality.

When choosing a clinic, carefully read the certificates and patents of the institution itself, as well as documents confirming the qualifications of doctors. It wouldn’t hurt to have positive reviews and recommendations from friends who have already used the services of this medical center.

Preventive measures

Prevention of alcohol dependence is based on the joint coordinated activities of doctors of various profiles, psychologists, teachers, educators, sociologists, lawyers, and various public and government organizations. It is carried out differentially and is divided into primary, secondary and tertiary.

Primary prevention is the prevention of the causes of alcoholism long before they appear. This type of prevention is the most widespread and nonspecific. This is predominantly a pedagogical, social and psychological impact aimed at children, adolescents and young people.

Secondary prevention involves people who already drink alcohol (early diagnosis, psychological support, social work with the environment and family members of the alcoholic).

Tertiary prevention includes assistance to people who have managed to cope with alcoholism (temperance clubs, societies like " Alcoholics Anonymous", psychological counseling for recovering patients, etc.).

With all the variety of methods and means of treating this very common addiction, it is important to understand that not one, even the most modern method alcoholism treatment does not guarantee results. It is impossible to effectively treat, let alone cure, an alcoholic without his own desire and effort.