Hi all, I have copied-and-pasted (below) a lengthy post I read on "Drugs-Forum", after getting permission by its author. I originally put it in the medication section of this site but have reposted it here after that was suggested to me by another member. It contains a lot of interesting info about alcoholism and the available treatments, and may hopefully be helpful to people who read it here, even though people will almost certainly disagree with aspects of it. The post was exactly as written below:
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Others have posted numerous ideas here already, but I'd just like to point out what I've read and also know from experience as an alcoholic, in case it can help anyone coming here in search of help for an alcohol problem. By the way I am aware of the self-incrimination rule on the forum, but nothing I say here outlines any illegal actions by me or recommends any to others.
Some people, about 1 in 10 from memory, have a different reaction to alcohol than most people. They feel greater euphoria from it and they seem unable to control their intake after having just one or two drinks. This is not something that happens to the majority who drink alcohol. It's not about being "weak" but is actually about the way the brain reacts to alcohol. The euphoria and paradoxical stimulant effect appear to happen due to alcohol's effects on the brain's natural opioids (endorphins) and the dopamine receptors, rather than its better-known effects on GABA receptors. This probably happens with everyone to some extent but it seems to happen to a lot greater extent to those 1 in 10 who go on to have serious alcohol problems. Feeling an overpowering need to keep on drinking after having the first drink or two seems to be an indication that a person's brain reacts this way to alcohol, and it is likely that their brain will always react chemically in this way, every time they drink any alcohol at all. This is probably the reason why alcoholics usually go straight back to serious drinking if they have any alcohol at all, even after months or years of total sobriety. Alcohol actually has an effect on numerous receptor/neurotransmitter types so it may also affect others in a way that causes the urge to drink more and more.
Another reason for drinkers becoming alcoholics would be using alcohol as self-medication for emotional, social, and other life problems. To some people it will initially seem like a very easy, legal, readily-available method of finding temporary escape from anxiety, depression, loneliness, insomnia, and many other personal problems. Unlike some prescription drugs like antidepressants it also "works" immediately; the same applies to many other recreational drugs. Once a person has used alcohol a few times for emotional relief they are not likely to forget about it, and they are extremely likely to turn to it again when they feel the need for relief. Doing this regularly would be very likely to lead to a serious alcohol problem, since memories of near-instant relief of inner discomfort are likely to become permanent. Unfortunately there seems to be no way of using alcohol is this way without descending into severe alcoholism sooner or later, and the alcohol is then likely to cause so many of its own problems (definitely including depression, loneliness, insomnia, and anxiety) that it will be impossible to gain much real relief using alcohol anymore. By the time a person gets to that stage, they are likely to be addicted and unable to quit for very long, even if they are fully aware of all the problems alcohol is causing them. Their original problems are also likely to remain unsolved by the alcohol. In time their entire lifestyle can become chaotic and marred by social isolation, relationship failures, emotional/psychiatric disability, physical degradation, long-term unemployment, and possible dereliction and homelessness. Another issue often not realised is that the person is constantly getting older and missing out on many years of their life, and they cannot go back in time to enjoy life as a younger person even after their recovery from alcoholism. The sooner alcoholism can be escaped from, the better!
Over many years, millions of alcoholics have battled with this problem and have usually found it too much to be able to beat by themselves once it has fully set in. That is the whole reason for the existence of AA...few people would choose to go to group metings for sobriety unless they could not overcome their problem by other ways, and most have probably tried virtually all the other ways of sobriety. Part of AA's beliefs is that alcoholism eventually becomes unable to be solved by any sort of human intervention/treatment alone, and that spiritual help is the only solution...the alcoholic is encouraged to turn their life over to a "Higher Power" as they understand that power, which many would call God. In AA there is also a place for human help, since getting a sponsor and attending meetings regularly is part of the program. Doing the 12 steps (not just reading about them) is recommended to all members seeking relief from their alcoholism, and an overall change of lifestyle and addressing of personal issues is a normal part of membership. Apart from anything else, attending AA regularly offers a new non-drinking social life for people. It must be noted that AA members are often against the idea of using any long-tern psychoactive medications, so what I say (below) about medications may be at odds with some aspects of AA. I do not recommend one way over the other, I am simply pointing out both.
Medications (usually a benzodiazepine like diazepam/Valium) exist to treat the initial withdrawal/detox period but that is simply a first step, as it only lasts a week or less in most cases and it only treats physical alcohol withdrawal. Detox does not treat psychological alcohol dependence or co-existing disorders, which is surely where the real problem lies. Inpatient rehabs treat patients for a few months but the person still has to live in the outside world sooner or later. Medications used in an attempt to reduce cravings for alcohol include naltrexone, acamprosate (Campral), and topiramate (Topamax). Disulfiram (Antabuse) is used as a deterrent to drinking because it makes a person dangerously ill if they try to drink after taking it. Unfortunately none of these medications has a huge long-term success rate but they should at least be given a fair chance of helping.
More recently there has been quite a lot of interest in baclofen as a drug to actually eliminate, rather than just reduce, alcohol cravings. It is a muscle relaxant and GABA-B agonist that has been around for many years, but which has only recently been of interest for alcoholism. A forum called My Way Out has numerous posts by people claiming to be trying it to get relief from alcoholism, and some claim it is successful. Most of the interest in the drug comes from the work of Dr Olivier Ameisen, who successfully treated his own alcoholism with it after failing to gain relief from any other treatment method. The one big problem with the drug seems to be the fact that unusually high doses are needed for successful alcoholism treatment, and Dr Ameisen himself needed a peak of 270 mg per day, before reducing to 120 mg/day. The usual recommended maximum daily dose is 75-80 mg per day, and this could make it extremely difficult to get enough of the drug prescribed by a doctor (also it isn't officially approved for alcoholism at any dose in most countries).
GHB has some effects similar to baclofen and has also been used to treat alcoholism, notable in Italy. There are also some reports here and there of anticonvulsant (antiepileptic) drugs apart from topiramate having potential in alcoholism treatment, perhaps both during acute detox and longer-term anti-craving treatment; a few that come to mind are carbamazepine (Tegretol), valproate/valproic acid, gabapentin (Neurontin), pregabalin (Lyrica), and possibly lamotrigine (Lamictal). The antinausea drug ondansetron has also been mentioned occasionally as having some use in alcoholism (outside acute treatment of nausea I mean).
One other approach, possibly a bit similar to the baclofen idea, is to use something as an alcohol substitute. This should probably only be recommended for people who have failed all other treatments for alcoholism, and who seem likely to drink themselves to an early grave (which unfortunately applies to a large number of alcoholics). I'm not going to recommend taking drugs on this forum or anywhere else, so I leave it up to the reader to think about this idea for themselves. Most or all things that could substitute for alcohol would be intoxicants aswell, and likely to cause tolerance and dependence, although rotating two substances that work differently in the brain could possibly slow the development of tolerance. Taking Antabuse at the same time as an alcohol substitute could maybe help the person avoid drinking alcohol on top of the substitute, which could be fatal if the other drug is a central nervous system depressant like alcohol is.
One more thing cannot be overlooked in the quest for freedom from alcoholism. The person is going to need a whole new lifestyle, new (non-drinking) activities and goals, and quite possibly treatment for underlying personal issues that will still exist when they are sober. AA provides much of this to its members; both members and non-members may also need further help in finding a new life and sorting through their personal problems.
Best wishes to all; I ask anyone reading this to correct me or present more accurate information if needed. Also I would urge anyone with an alcohol problem to consult a doctor before attempting any medical treatment, especially since abruptly quitting or cutting down alcohol intake can be fatal if not medically managed.
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Others have posted numerous ideas here already, but I'd just like to point out what I've read and also know from experience as an alcoholic, in case it can help anyone coming here in search of help for an alcohol problem. By the way I am aware of the self-incrimination rule on the forum, but nothing I say here outlines any illegal actions by me or recommends any to others.
Some people, about 1 in 10 from memory, have a different reaction to alcohol than most people. They feel greater euphoria from it and they seem unable to control their intake after having just one or two drinks. This is not something that happens to the majority who drink alcohol. It's not about being "weak" but is actually about the way the brain reacts to alcohol. The euphoria and paradoxical stimulant effect appear to happen due to alcohol's effects on the brain's natural opioids (endorphins) and the dopamine receptors, rather than its better-known effects on GABA receptors. This probably happens with everyone to some extent but it seems to happen to a lot greater extent to those 1 in 10 who go on to have serious alcohol problems. Feeling an overpowering need to keep on drinking after having the first drink or two seems to be an indication that a person's brain reacts this way to alcohol, and it is likely that their brain will always react chemically in this way, every time they drink any alcohol at all. This is probably the reason why alcoholics usually go straight back to serious drinking if they have any alcohol at all, even after months or years of total sobriety. Alcohol actually has an effect on numerous receptor/neurotransmitter types so it may also affect others in a way that causes the urge to drink more and more.
Another reason for drinkers becoming alcoholics would be using alcohol as self-medication for emotional, social, and other life problems. To some people it will initially seem like a very easy, legal, readily-available method of finding temporary escape from anxiety, depression, loneliness, insomnia, and many other personal problems. Unlike some prescription drugs like antidepressants it also "works" immediately; the same applies to many other recreational drugs. Once a person has used alcohol a few times for emotional relief they are not likely to forget about it, and they are extremely likely to turn to it again when they feel the need for relief. Doing this regularly would be very likely to lead to a serious alcohol problem, since memories of near-instant relief of inner discomfort are likely to become permanent. Unfortunately there seems to be no way of using alcohol is this way without descending into severe alcoholism sooner or later, and the alcohol is then likely to cause so many of its own problems (definitely including depression, loneliness, insomnia, and anxiety) that it will be impossible to gain much real relief using alcohol anymore. By the time a person gets to that stage, they are likely to be addicted and unable to quit for very long, even if they are fully aware of all the problems alcohol is causing them. Their original problems are also likely to remain unsolved by the alcohol. In time their entire lifestyle can become chaotic and marred by social isolation, relationship failures, emotional/psychiatric disability, physical degradation, long-term unemployment, and possible dereliction and homelessness. Another issue often not realised is that the person is constantly getting older and missing out on many years of their life, and they cannot go back in time to enjoy life as a younger person even after their recovery from alcoholism. The sooner alcoholism can be escaped from, the better!
Over many years, millions of alcoholics have battled with this problem and have usually found it too much to be able to beat by themselves once it has fully set in. That is the whole reason for the existence of AA...few people would choose to go to group metings for sobriety unless they could not overcome their problem by other ways, and most have probably tried virtually all the other ways of sobriety. Part of AA's beliefs is that alcoholism eventually becomes unable to be solved by any sort of human intervention/treatment alone, and that spiritual help is the only solution...the alcoholic is encouraged to turn their life over to a "Higher Power" as they understand that power, which many would call God. In AA there is also a place for human help, since getting a sponsor and attending meetings regularly is part of the program. Doing the 12 steps (not just reading about them) is recommended to all members seeking relief from their alcoholism, and an overall change of lifestyle and addressing of personal issues is a normal part of membership. Apart from anything else, attending AA regularly offers a new non-drinking social life for people. It must be noted that AA members are often against the idea of using any long-tern psychoactive medications, so what I say (below) about medications may be at odds with some aspects of AA. I do not recommend one way over the other, I am simply pointing out both.
Medications (usually a benzodiazepine like diazepam/Valium) exist to treat the initial withdrawal/detox period but that is simply a first step, as it only lasts a week or less in most cases and it only treats physical alcohol withdrawal. Detox does not treat psychological alcohol dependence or co-existing disorders, which is surely where the real problem lies. Inpatient rehabs treat patients for a few months but the person still has to live in the outside world sooner or later. Medications used in an attempt to reduce cravings for alcohol include naltrexone, acamprosate (Campral), and topiramate (Topamax). Disulfiram (Antabuse) is used as a deterrent to drinking because it makes a person dangerously ill if they try to drink after taking it. Unfortunately none of these medications has a huge long-term success rate but they should at least be given a fair chance of helping.
More recently there has been quite a lot of interest in baclofen as a drug to actually eliminate, rather than just reduce, alcohol cravings. It is a muscle relaxant and GABA-B agonist that has been around for many years, but which has only recently been of interest for alcoholism. A forum called My Way Out has numerous posts by people claiming to be trying it to get relief from alcoholism, and some claim it is successful. Most of the interest in the drug comes from the work of Dr Olivier Ameisen, who successfully treated his own alcoholism with it after failing to gain relief from any other treatment method. The one big problem with the drug seems to be the fact that unusually high doses are needed for successful alcoholism treatment, and Dr Ameisen himself needed a peak of 270 mg per day, before reducing to 120 mg/day. The usual recommended maximum daily dose is 75-80 mg per day, and this could make it extremely difficult to get enough of the drug prescribed by a doctor (also it isn't officially approved for alcoholism at any dose in most countries).
GHB has some effects similar to baclofen and has also been used to treat alcoholism, notable in Italy. There are also some reports here and there of anticonvulsant (antiepileptic) drugs apart from topiramate having potential in alcoholism treatment, perhaps both during acute detox and longer-term anti-craving treatment; a few that come to mind are carbamazepine (Tegretol), valproate/valproic acid, gabapentin (Neurontin), pregabalin (Lyrica), and possibly lamotrigine (Lamictal). The antinausea drug ondansetron has also been mentioned occasionally as having some use in alcoholism (outside acute treatment of nausea I mean).
One other approach, possibly a bit similar to the baclofen idea, is to use something as an alcohol substitute. This should probably only be recommended for people who have failed all other treatments for alcoholism, and who seem likely to drink themselves to an early grave (which unfortunately applies to a large number of alcoholics). I'm not going to recommend taking drugs on this forum or anywhere else, so I leave it up to the reader to think about this idea for themselves. Most or all things that could substitute for alcohol would be intoxicants aswell, and likely to cause tolerance and dependence, although rotating two substances that work differently in the brain could possibly slow the development of tolerance. Taking Antabuse at the same time as an alcohol substitute could maybe help the person avoid drinking alcohol on top of the substitute, which could be fatal if the other drug is a central nervous system depressant like alcohol is.
One more thing cannot be overlooked in the quest for freedom from alcoholism. The person is going to need a whole new lifestyle, new (non-drinking) activities and goals, and quite possibly treatment for underlying personal issues that will still exist when they are sober. AA provides much of this to its members; both members and non-members may also need further help in finding a new life and sorting through their personal problems.
Best wishes to all; I ask anyone reading this to correct me or present more accurate information if needed. Also I would urge anyone with an alcohol problem to consult a doctor before attempting any medical treatment, especially since abruptly quitting or cutting down alcohol intake can be fatal if not medically managed.
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