Alcoholism and alcohol dependency are devastating for the mental, emotional, and physical wellbeing of an individual. Despite its many health risks, this issue fails to garner the attention it deserves. Most alcoholics don’t seek treatment, and their family and friends fail to stage timely interventions.
Many individuals combine the use of alcohol with other drugs and illicit substances. Such mixing triggers devastating complications in the brain. Alcoholism destroys life quality, health, and mental wellbeing, and overcoming this condition is not easy. Patients need all the help they can get through medicine, therapies, group sessions, moral support, and more.
Experts typically recommend medical detox for alcohol dependency as the body experiences severe withdrawal symptoms. Treating alcoholism requires a multifaceted approach, including medications, cognitive-behavioral therapy (CBT), and lifestyle changes. Most inpatient rehab centers for substance abuse in Texas use complementary therapies, like yoga and massage, to treat alcoholism.
Medications are necessary and instrumental in easing the discomfort caused by patients struggling to quit. This discomfort also makes them more likely to relapse. Therefore, medical detox for alcohol withdrawal is necessary, and Disulfiram is a popularly prescribed FDA-approved medication.
Keep reading to learn more about Disulfiram and how it works in treating alcoholism.
Disulfiram: Treating Alcoholism
Disulfiram, sold under the brand name Antabuse, is a widely prescribed medication to treat alcoholism. It is pertinent to mention here that Disulfiram is the first FDA-approved medication available to be administered to alcoholics during recovery. It has been prescribed by addiction specialists for the last six decades, with largely successful results. This medication has proven effective in aiding patients to achieve and maintain their sobriety.
However, it is important to note that Disulfiram is only the medicinal aspect of a multifaceted alcohol dependency treatment. Disulfiram is by no means meant to be used as a standalone cure. It is only effective in treating alcoholism when combined with CBT, individual counseling, and group therapy.
It is common for an inpatient rehab center for substance abuse in Texas to initiate a detox course with Disulfiram. However, this medical detox course will also include outpatient and inpatient rehabilitation, AUD counseling strategies, and group therapy sessions.
A comprehensive clinical review examined the results of major clinical trials involving Disulfiram spanning over 60 years. After exploring multiple clinical studies, the review concluded that Disulfiram is a viable treatment option for alcoholism. The authors observed that its effectiveness in treating alcohol dependency is greater than that of popular medications naltrexone and acamprosate.
The review further reveals that Disulfiram is particularly effective at treating patients with a dual diagnosis. For instance, patients suffering from cocaine and alcohol dependency are commonly prescribed Disulfiram to help achieve sobriety. The authors highlight that previously, Disulfiram’s usefulness was attributed to its psychologically deterring effects.
However, recently conducted studies are turning attention towards the anti-craving effects of this medication. Supervised disulfiram therapy aids patients in building up a strong mental resistance to overcome alcohol dependency.
Most addiction specialists prescribe Antabuse in medical detox for alcohol dependency during the initial detoxification phase. A psychiatrist or addiction specialist can also prescribe Disulfiram after detoxification, once the body is fully drained of alcohol. Some addiction medication experts believe that Disulfiram is most useful after withdrawal symptoms disappear.
In severe cases of alcoholism, Antabuse is prescribed alongside benzodiazepines to ease withdrawal symptoms and discomfort. A meta-analysis consisting of 11 randomized control trials attempted to examine the effects of Disulfiram in treating alcoholism. The researchers examined data obtained from over 1500 patients.
They concluded that supervised Disulfiram aids in achieving short-term abstinence. It also increases the days until relapse and reduces the number of drinking days. More importantly, it has proven more effective than most other treatments for alcoholism and substance abuse.
Patients can continue taking Disulfiram for longer periods if it is deemed necessary to maintain sobriety. If a patient and their addiction specialist decide that Disulfiram is no longer necessary for long-term recovery, they can discontinue the course of treatment.
Treating Alcoholism: How Does It Work?
Disulfiram aids alcoholics in overcoming their drinking habit by triggering adverse reactions when they consume alcohol. Providers strongly advise patients on long-term use to stop drinking to prevent adverse effects. It is a widely researched, clinically studied, and extensively documented drug, with years of success in pharmacological addiction treatments.
Statistics reveal that Disulfiram can boost the abstinence rate of a patient by a striking 50%. Clinical research verifies that patients who have been prescribed Disulfiram for around 20 months exhibited the highest abstinence rates. Presently, over 18 million people across the US suffer from alcoholism or an alcohol use disorder.
It is important to avoid self-medication and seek out a supervised medical detox for alcohol. Disulfiram can bring about effective results, but what mechanisms come into play while treating alcoholism?
Let’s take a look at a biological explanation for Antabuse’s effectiveness.
A Biological Explanation of Disulfiram
In order to understand how Disulfiram works, it’s crucial to understand how the human body metabolizes alcohol. When alcohol is ingested, the body’s metabolism converts it into a highly toxic compound – acetaldehyde.
Research reveals acetaldehyde is responsible for those awful hangover symptoms we experience after a night of heavy drinking. When consumed occasionally, the body’s normal response is to oxidize this toxic substance into acetic acid. This process is natural and harmless. However, complications arise when individuals start developing an alcohol dependency and binge-drinking routines.
Antabuse works by interfering with the natural metabolic processes of the body. It prevents the body from creating acetic acid, leading to an accumulation of acetaldehyde, which aggravates the hangover symptoms.
So, how does Disulfiram work?
Clinical reviews reveal that, unlike most FDA-approved medications for alcoholism, Disulfiram does not influence brain opiates. Antabuse does not directly affect glutamate receptors or the y-aminobutyric acid. However, it does impact the central nervous system and serotonergic functions. Simply put, it reduces the urge to consume alcohol, making it easier for the patient to resist cravings.
Suppose you’re considering a 90-day residential treatment center for men in DFW. In that case, it’s likely for Disulfiram to be a part of your treatment to overcome substance dependency. Observers note that Disulfiram disrupts the body’s natural process of metabolizing alcohol.
This is primarily why interaction between Disulfiram and alcohol can produce mild to severe side-effects. We’ll discuss this reaction in more detail later.
Experts typically prescribe Disulfiram alongside psychosocial treatments and counseling. It is also prescribed to patients who can abstain from alcohol for at least 12 hours at a time. Patients who are committed to abstinence and maintaining sobriety are prescribed Disulfiram increase their chances of recovery.
Patients who suffer from heart complications and chronic ailments are usually not prescribed such medications.
Positive Clinical Findings of Antabuse
There is a wealth of clinical research and studies that verify Disulfiram’s effectiveness in treating patients with alcoholism. A clinical review observes that the effectiveness of Disulfiram largely depends on the level and quality of supervision of the patient. If you’re considering a medical detox for alcohol dependency, find a credible inpatient rehab center for substance abuse in Texas.
Pharmacological treatments for alcohol dependence are only successful under the close supervision of addiction medicine specialists.
Interestingly, a study reveals that DVA medical centers in the US use court-mandated Disulfiram therapy to boost recovery rates. The Department of Veterans Affairs (DVA) supported a court-ordered Disulfiram treatment to increase recovery rates amongst veterans. Many of these veterans also had post-traumatic stress disorder and other overlapping mental health conditions.
However, medical detox for alcohol is used in conjunction with other incentives to ensure patient adherence to the regimen. Patients are given regular reminders, support, counseling, behavioral training, and a Disulfiram regime to boost recovery and abstinence rates.
Marc Schuckit, a leading authority on treating alcohol addiction, agrees that Disulfiram can help increase recovery rates. In his insightful clinical guide, Schuckit observes that Disulfiram increases the effectiveness of an inpatient specialty treatment program.
Some experts argue that Disulfiram only aids in achieving short-term abstinence and retaining sobriety after detoxification. However, the most comprehensive review of Disulfiram therapy proves otherwise.
The most rigorous research on Disulfiram therapy, the paper notes that a daily dose reduces alcohol consumption. It concluded that 250mg of the drug increased alcohol abstinence in male veterans throughout the year-long study.
Disulfiram therapy is a popular pharmacological treatment used in conjunction with behavioral and cognitive therapies. Its effectiveness is well-established, but its potential risks are also important to consider.
Does Disulfiram Have Any Side-Effects?
All medicinal drugs have risks and benefits, and Disulfiram is no different in this regard. A specialist at any inpatient rehab center for substance abuse in Texas is likely to prescribe Disulfiram in supervised settings. Supervised Disulfiram courses help addiction specialists outweigh potential risks and maximize benefits to treat patients effectively.
Most of the risks arise when Antabuse is misdiagnosed or used inaccurately. It can lead to fatal complications when consumed with alcohol and other illicit substances. We’ll discuss the side-effects of Disulfiram shortly; first, let’s take a look at its interactions with alcohol.
The Disulfiram-Alcohol Reaction
The adverse interaction between alcohol and Disulfiram is scientifically termed as the Disulfiram-alcohol reaction. An insightful treatise by the Center for Substance Abuse Treatment examined this reaction’s effects by reviewing clinical trials. The authors explained that the Disulfiram-alcohol reaction typically occurs around 10-30 minutes after ingesting alcohol.
The adverse effects range from moderate to severe, depending on the patient’s physical and mental characteristics. This reaction also varies depending on the exact dosage of alcohol and Disulfiram ingested by the patient. Blood concentrations of 5-10mg/100mL can trigger mild effects, while 150mg/100mL can render an individual unconscious.
Doctors typically examine the health records and conduct careful screening of patients before prescribing Disulfiram. The reaction typically leads to the following symptoms:
- Warmth & flushing
- Respiratory complications
- Respiratory depression
- Foul breath odor
- Blurred vision
- Throbbing pain in head, throat and neck
- Stomach complications
- Digestive complications
- Chest pain and heart palpitations
- Cardiovascular collapse
- Myocardial infarction (in patients diagnosed with an arterial disease)
- Acute congestive heart failure (in patients diagnosed with myocardial dysfunction)
Managing a Disulfiram-alcohol reaction can prove extremely challenging. It typically lasts for 30-60 minutes, but it can last for several hours in severe cases. When the reaction is severe, the patient will need immediate support to reduce blood pressure and heart rate. In some cases, patients also require shock treatment and revival from unconsciousness.
Patients who’ve suffered a reaction are typically rushed to the ER to ensure immediate medical attention. Only a healthcare professional can administer the right medications and observe potassium readings in the body to ensure recovery. It is also wise to inform the addiction specialist who prescribed Disulfiram if such an emergency occurs.
Patients are also advised to avoid long-term use of Disulfiram and seek out holistic lifestyle changes to maintain sobriety.
Patients and caregivers are firmly advised to seek the assistance of a licensed addiction specialist. It is wise to seek out a reputed facility for alcohol and substance use disorder near Dallas-Fort Worth. Male patients can consider a credible 90-day residential treatment center for men in DFW.
Pharmacological treatments are only effective when prescribed by your specialist as part of the 12-step program. It is crucial to consult your provider about the potential risks associated with the long-term use of Disulfiram.
Patient Education and Awareness
Patient and caregiver awareness is instrumental in ensuring a successful medical detox for alcohol dependence. It is wise to consult experts at your nearest inpatient rehab center for substance abuse in Texas to obtain resources. Patients must receive extensive education and materials to learn about Disulfiram therapy.
Experts strongly advise using Disulfiram in supervised and well-monitored settings with a multifaceted and interdisciplinary medical team. It should be a part of a specialized alcohol dependence treatment program alongside counseling and lifestyle changes. Family members can help patients educate themselves through motivation and by staging a supportive intervention.
Disulfiram is unlikely to exhibit a strong influence on drinking patterns across individuals with poor medication compliance.
Here are some key factors that patients need to educate themselves on before beginning Disulfiram therapy:
- The effects and influences of Disulfiram
- Risk factors and symptoms of the Disulfiram-alcohol reaction
- Firm precautions about alcohol consumption while taking Disulfiram
- Warnings about ingesting alcohol disguised in sweets, cakes, vinegar, cough medications, sauces, aftershave, beauty products, toiletries, and other forms.
- The significance of prioritizing counseling over long-term Disulfiram therapy and finishing the 12-step program while taking the medication.
- Significance of informing physicians, dentists, and healthcare providers about taking Disulfiram to prevent adverse reactions, especially when scheduled for surgery.
- The need to inform prescribing addiction specialists in case of a relapse or Disulfiram-alcohol reaction.
- Risk factors and symptoms of potential neurologic complications.
Patients who have prescribed Disulfiram and have a higher risk of relapse are asked to carry a safety identification card. This card helps identify that the patient is suffering an adverse reaction caused by the medication. It will also provide the number of the prescribing specialist or facility in case of an emergency.
Is Disulfiram Therapy the Right Treatment for You?
Only an addiction medicine specialist can determine if Disulfiram therapy is the right treatment for a patient. They make this determination on a case-by-case and patient-by-patient basis. It depends on various reasons, including the severity of alcohol dependency, relapse risk, and overlapping symptoms.
Here are the patients who are considered ideal for entering into Disulfiram therapy:
- Patients with higher medical compliance.
- Patients who can sign up for an inpatient alcohol treatment program and take supervised Disulfiram dosing.
- Individuals who are motivated to overcome and committed to achieving sobriety.
- Patients who are physically struggling to achieve total abstinence despite their commitment.
- Patients who are responsible and understand the adverse complications caused by the Disulfiram-alcohol reaction.
- Patients who can successfully abstain from alcohol during the dosing period.
- Patients who have a codependency on cocaine abuse or other illicit substances.
Disulfiram Therapy: Treatment, Duration and Discontinuation
Experts firmly advise against the prolonged use of Disulfiram. It does not aid in building a tolerance for alcohol and suppressing cravings to achieve long-term sobriety. Typically, providers prescribe Disulfiram to establish stability and help the patient work towards long-term abstinence. It can continue for several months or several years, depending on the patient’s condition and dependence severity.
A 9-year long clinical review examined the effects of supervised Disulfiram therapy across 180 patients with chronic alcohol dependence. The study conducted that 12-20 month supervised Disulfiram therapy brings about beneficial psychological actions. Its effects are more psychological than pharmacological.
The study also concluded that a patient is more likely to maintain sobriety after terminating medication and Disulfiram therapy. Supervised medication therapy is part of an initial treatment, which may take longer for some patients. It is pertinent to avoid self-medication and seek a reputable inpatient rehab center for substance abuse in Texas.
It is also crucial to consult and inform the prescribing professional about continuing Disulfiram after getting discharged from the facility. Patients often continue taking medications that they deem “helpful” in maintaining their abstinence. But they struggle to add group therapy, AAA meetings, and counseling sessions to their daily schedules.
Losing touch with your care provider after getting discharged from rehab is common. It is also common for patients to build a reliance or habit to consume the medications that helped them achieve sobriety. But the long-term use of a medication without consulting your doctor can prove drastically adverse.
In certain cases, doctors advise their patients to restart Disulfiram therapy even after completing a successful treatment and maintaining sobriety. Patients often need pharmacological assistance in high-risk situations, like weddings, traveling, and social events. In such situations, it is wise to undertake behavioral interventions and Disulfiram therapy to maintain abstinence.
It is interesting to note that discontinuing Disulfiram is not associated with any side-effects or withdrawal symptoms. However, patients are strongly advised to avoid consuming alcohol for at least two weeks of discontinuing the drug. Disulfiram-alcohol reactions can occur up to 2 weeks after discontinuing.
Alcoholism is a difficult disease to treat. It’s one that comes with many complications and has both physical and mental effects. Hence, finding an effective treatment for a patient is necessary.
Clinical research and evaluations on Disulfiram verify its clinical efficacy in achieving sobriety and treating alcohol dependence. However, it is pertinent to note that this efficacy is only established when Disulfiram is prescribed in supervised settings. For effective results, patients must be motivated and encouraged to get treated.
Patients who are not committed to abstaining and an inpatient Disulfiram treatment under supervision are not prescribed Disulfiram. Patients who are actively participating in their treatment and recovery can enjoy the greatest advantages of this medication.
In some studies, Disulfiram almost produces the same abstinence rates as a placebo, which indicates that many of the significant effects are psychological. This finding also correlates with the fact that discontinuing Disulfiram does not cause any withdrawal symptoms.
Some studies highlight the rare yet grave risk factors of neurologic and hepatic toxicity triggered by this medication. Therefore, the need for careful supervision and clinical settings cannot be stressed enough to monitor Disulfiram therapy. Patients considering this treatment are strongly advised to find a notable facility for substance use disorder near Dallas-Fort Worth.
It is an ideal treatment course for alcoholics who do not exhibit any contraindications and are aiming for complete abstinence. If you’re committed to struggle against alcoholism and embark on the road to recovery, get the help you need immediately. A well-reputed substance abuse facility will help you access the right resources and healthcare professionals to begin the journey toward sobriety.
John Eckelbarger is a Business Development Representative for Stonegate Center. With a BSA in Chemistry from the University of Texas at Austin, he has an interest in the neurobiology of addiction as well as the pharmacology of drugs. He hopes to bolster Stonegate Center’s status at the forefront of addiction medicine through bold, innovative content creation. He is currently pursuing his MBA in Finance from Texas Christian University.