Successful treatment of alcoholism is possible only if the patient himself wants it. Given the fact that alcoholics in most cases do not consider themselves as such, it is first necessary to carry out explanatory work with them. If this cannot be done in the family, then you can use the services of narcologists, psychotherapists, and psychiatrists. Treatment can be carried out both in the outpatient setting and in the hospital. The choice of treatment conditions, on the one hand, is determined by the desire of the patient, and on the other hand, depends on his mental and physical condition. In cases of severe hangover, with severe somatic and mental disorders, in the presence of psychotic episodes in the past, inpatient treatment is indicated.
At stage 1, detoxification therapy is carried out, usually in those cases when, when admitted to hospital, a hangover syndrome is expressed or the binge is interrupted. Various means are used for detoxification, mainly using the parenteral route of administration (intravenous or intramuscular). Unithiol, magnesium sulfate, vitamins B1, B6, C, nootropes (nootropil, piracetam, pyrroxan) are used. When expressed mental disorders prescribe tranquilizers (seduksen, Relanium, phenazepam, tazepam). When sleep disorders are used, Radedorm is used, and in cases of insomnia with nightmares, fear, anxiety, barbiturates (barbamyl, luminal). The patient is recommended to drink plenty (mineral water, juices, fruit drinks) with the simultaneous appointment of diuretics. For severe somatic disorders (diseases of internal organs), the patient consults a therapist and in addition is prescribed treatment aimed at the elimination of certain disorders.
You need a high-calorie, vitamin-rich diet. With a strong depletion of the patient prescribed small (4-6 ED) insulin dose to increase the appetite.
At achievement of a good state, mental and somatic, carry out anti-alcohol treatment. It is chosen together with the patient and his relatives, the essence and consequences of the proposed methods are explained. Throughout the entire treatment process, psychotherapy should be applied, which contributes to the development of the patient’s setting for treatment and a sober lifestyle. The treatment will be effective only when the patient believes the doctor, when the necessary contact, mutual understanding and trust have been established.
One of the methods of treatment is conditioned reflex therapy. The essence of the method is to develop a conditioned-reflex reaction in the form of vomiting on the taste or smell of alcohol. This is achieved by the combined use of emetics (decoction of baranza, injection of apomorphine) and small amounts of alcohol. Treatment is carried out daily or every other day. In the course of treatment - 2025 sessions. Conditioned reflex therapy is most effective in patients with stage 1, and especially in women, who usually do not tolerate vomiting and react with aversion to the treatment procedure itself.
The method of sensitization therapy. Its purpose is to suppress the craving for alcohol and to create the conditions for involuntary refraining from taking alcohol. The patient is given daily antabus (teturam), which itself is harmless. However, when alcohol enters the body (even a small amount of beer, wine) an interaction reaction occurs, the consequences of which can be very difficult and unpredictable.
One of the variants of this type of therapy is the creation of a depot of the drug in the body, for which the drug Esperal is subcutaneously or intramuscularly implanted (usually in the gluteal region). Esperal represents 10 coated tablets, sealed in a sterile vial. The reaction to the drug in the body occurs only in the case of alcohol. Deaths are possible. The patient is warned about the possible consequences of a violation of the mode of sobriety, about which he gives a receipt, which, in turn, is a legal document for the doctor to justify his actions.
Psychotherapy is applied from the first visit to the sick doctor and accompanies the entire treatment process. Explanatory psychotherapy is aimed at explaining the essence of the disease, its harm and harmful consequences, the development of a setting for treatment and a long sober lifestyle. The patient must understand that he is no longer able to drink “like everything” and that he cannot do without the help of a doctor. In addition to explanatory psychotherapy, other methods are used.
Hypnotherapy (hypnosis) - suggestion in a state of hypnotic sleep. It is shown to patients easily suggestible and believing in the effectiveness of this method. It is used both individually and in specially selected groups (group hypnosis).
A special kind of psychotherapy is coding. Copyright methods for which doctors have exclusive rights.
Group rational psychotherapy. For this type of treatment, a small group of patients (about 10 people) are selected, united by a common psychological and social problems, which helps to establish emotional ties between them, feelings of mutual trust, belonging to a special group. Patients discuss with the doctor and among themselves a variety of life problems, primarily related to alcoholism. Joint discussion of various issues allows patients to look at themselves differently, to assess their behavior. The special atmosphere of mutual respect and trust allows us to develop a certain lifestyle, with other (sober) attitudes and aspirations, to believe in ourselves and our capabilities.
Remissions and relapses. After discharge from the hospital, the first 1-2 months are the most difficult for the patient when they have to adapt to the new role of a non-drinker. During this period, it is necessary to rehabilitate at work, to establish relationships in the family, to compose a "legend" for your drinking companions as an excuse for a sober lifestyle. Moral support in the family, from friends, employees, is a necessary condition for the development of high-quality remission.
The craving for alcohol can persist for quite a long time, depending on the severity of the disease. It is usually accompanied by the same vegetative and mental disorders that were observed in the state of hangover. Therefore, such a condition arising against the background of absolute sobriety is called a pseudoabstinent syndrome. The patient becomes irritable, agitated, "breaks down" on his wife and children, does not find a place for himself. At discharge, the doctor usually gives advice on what to do in such cases so that there is no “breakdown” - a return to drunkenness. If there were no recommendations, you need to consult a doctor and, possibly, undergo a preventive course of treatment. The easiest way to avoid alcoholism: if there is a desire to "drink", you need to eat well and tasty, and with a full stomach, as you know, this desire disappears. In addition, you need to take a sedative (seduxen, phenazepam, sonapax - 1-2 tablets) and take them regularly until the condition improves and the craving for alcohol disappears. Psychotropic drugs and their doses must be coordinated with the doctor.