Treating Alcoholism As a Chronic Disease: Approaches to Long-Term Continuing Care PMC

This review has outlined the current therapeutic armamentarium although there remains geographic variation in the availability of some treatments. Alcohol is a major cause of liver disease globally and is overrepresented as an aetiology of liver disease in the developed world. ALD exists on a broad clinical spectrum, with many https://ecosoberhouse.com/article/meth-addiction-and-abuse-symptoms-and-treatment/ cases remaining undiagnosed. As such, it is important for clinicians to remain cognisant and screen for it routinely in clinical practice.

• Thus, both of these studies indicate that continuing care involving extended intensive monitoring can generate positive outcomes, at least in highly motivated patients.
• Naltrexone is well tolerated in compensated cirrhosis, but dose-dependent hepatotoxicity has been demonstrated in obesity trials and monitoring of liver function tests is recommended 84.
• After that, patients enter the continuing-care phase, which typically involves one 12-step– oriented group session per week.
• In general, treatments for alcohol use disorder aim to alleviate withdrawal symptoms, stop or reduce alcohol use, and give patients behavioral skills and knowledge that can help them either stop drinking or maintain a healthy level of alcohol use.

What is the outlook for people who have alcohol use disorder?

In a second study, a modified version of this enhanced treatment was compared with intensive day therapy only. Again, participants who were offered abstinence-contingent access to work therapy and housing showed better outcomes (e.g., greater treatment participation, higher abstinence rates, and less homelessness) than participants in the control condition (Milby et al. 2000). Yale Medicine’s approach to alcohol use disorder is evidence-based, integrated, and individualized. Our specialists utilize a range of medication and behavioral methods with demonstrated efficacy for helping individuals change their drinking habits and maintain these changes long-term.

Do you feel ANNOYED because other people have criticized your drinking?

The composition of regular attendees can vary greatly, and some groups may attract certain subgroups of addicts (e.g., younger people, women, or nonsmokers). Therefore, new members may have to try out several meetings to find a group that is most appropriate for them. In addition, self-help programs with a more secular focus (e.g., SMART Recovery, Rational Recovery, or Save Our Selves SOS) are available for those people who are uncomfortable with the religious aspect of AA. Although initial treatment in an outpatient setting has many advantages, it also has some disadvantages compared with inpatient treatment.

The role of mental health in treating AUD

It can be hard to identify the lines between casual and occasional drinking and unhealthy alcohol use including alcohol use disorder. Alcohol is a leading cause of morbidity and mortality, responsible for more than 5% of global deaths and disability-adjusted life years (DALYs) 2. Young people are disproportionately affected, with alcohol being the leading cause of death and disability in those aged 15–49 years 7. Alcohol also causes significant extrahepatic harm through traumatic injuries, cardiovascular disease, mental health problems, various neoplasms, and exacerbation of infectious disease 2, 7. Alcohol is responsible for 48% of all cirrhosis-related deaths and 10% of all liver cancers, however this is not equally distributed between nations 2.

A second trend is the design of alternative treatment delivery modes that may be able to reach patients with limited access to or interest in traditional settings and strategies. However, many of these studies have been conducted in patients with a range of AOD disorders rather than focusing on patients with alcohol use disorders why is alcoholism considered a chronic disease only. People who drink too much alcohol are at risk of developing a host of health conditions and disorders including certain types of cancer, liver disease, and heart disease. Excessive alcohol consumption can damage the brain and other organs, and it also increases the chances of developing sleep problems, depression, and other mental health problems.

Diagnosing alcohol use disorder

Everyone’s road to recovery differs; treatments can occur in an inpatient or outpatient medical settings, individual or group sessions with therapists, or other specialty programs. Chronic diseases are the leading cause of death and disability in the U.S., accounting for about 70 percent of all deaths. The CDC cites the major risk factors for chronic disease as tobacco use, lack of physical exercise, poor nutrition, and excessive alcohol use. A third medication, disulfiram also is approved for the treatment of alcoholism.

The progression of the disease is subtle, and usually takes place over such an extended period, that even the alcoholic themselves fails to notice the point at which they lost control and alcohol took over their life. When this happens, research shows, alcoholics and addicts have a reduced ability to control their powerful impulse to use the substance, even when they are aware it is not in their best interest. At this point, their reward system has become pathological, or, in other words, diseased. The problem is the alcoholic’s mental obsession with alcohol is much more subtle than a song playing in one’s mind. This explains why individuals who chronically abuse drugs or alcohol begin to appear lethargic, unmotivated and depressed, and report a lack of pleasure in things that were once pleasurable. To counter this, they increase their substance use in an attempt to feel the same pleasure they used to.

• Alcoholism is a term that is sometimes used to describe what is known as an alcohol use disorder (AUD).
• Thus, at all times during the telephone contacts, it is important that the counselor be on the lookout for signs of trouble in what the patient says (or does not say), and that the counselor immediately addresses such issues.
• If the consequences of your behaviour around alcohol remained the same, there may be little to no incentive to change.
• Single specialties are ill-equipped to manage the complexities of ALD alone, as holistic treatment requires simultaneous consideration of comorbid liver disease, alcohol use disorder (AUD), mental illness, and other psychosocial issues (Fig. 2).
• To maintain their license to practice medicine, these physicians must undergo intensive treatment that is coordinated and strictly monitored by State Physician Health Programs (PHPs) for several years.

A simplistic definition calls alcoholism a disease caused by chronic, compulsive drinking. A purely pharmacological-physiological definition of alcoholism classifies it as a drug addiction that requires imbibing increasing doses to produce desired effects and that causes a withdrawal syndrome when drinking is stopped. This definition is inadequate, however, because alcoholics, unlike other drug addicts, do not always need ever-increasing doses of alcohol.

Support groups

Hosted by Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares strategies for coping with alcohol cravings and other addictions, featuring addiction specialist John Umhau, MD. The same dopamine neurotransmitters affected by alcohol and other substances are also involved in the ability to feel pleasure from ordinary pursuits such as eating food, having sex, and engaging in social interaction. Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.