Successful treatment of alcoholism is possible only if the patient himself wants it. Considering the fact that alcoholics in most cases do not consider themselves as such, preliminary explanatory work is necessary with them. If this cannot be done in the family, then you can use the services of narcologists, psychotherapists, psychiatrists. Treatment can be carried out both on an outpatient basis and in a 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 the first stage, detoxification therapy is carried out, usually in cases when, upon admission to the hospital, a hangover syndrome is expressed or it is necessary to interrupt the binge. Various means are used for detoxification, mainly using the parenteral route of administration (intravenous or intramuscular). Unithiol, magnesium sulfate, vitamins B1, B6, C, nootropics (nootropil, piracetam, pyroxan) are used. With severe mental disorders, tranquilizers are prescribed (seduxen, relanium, phenazepam, tazepam). In cases of sleep disturbances, Ramedorm is used, and in cases of insomnia with nightmares, fear, anxiety, barbiturates (barbamil, luminal) are used. The patient is recommended to drink plenty of water (mineral water, juices, fruit drinks) with the simultaneous appointment of diuretics. In severe somatic disorders (diseases of the internal organs), the patient is consulted by a therapist and treatment is additionally prescribed aimed at eliminating certain disorders.
You need a high-calorie, vitamin-rich diet. With severe exhaustion of the patient, small (4-6 IU) doses of insulin are prescribed to increase appetite.
Upon reaching a good state, mental and somatic, anti-alcohol treatment is carried out. His choice is carried out 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 used to help develop the patient’s attitude towards treatment and a sober lifestyle. Treatment will be effective only if the patient believed the doctor, when the necessary contact, understanding and trust were established.
One of the treatment methods is conditioned reflex therapy. The essence of the method is to develop a conditioned reflex reaction in the form of vomiting for the taste or smell of alcohol. This is achieved by the combined use of emetics (rams decoction, injections of apomorphine) and small amounts of alcohol. Treatment is carried out daily or every other day. The course of treatment - 2025 sessions. The conditioned reflex therapy is most effective in patients in stage 1, and especially in women, who usually do not tolerate vomiting and react with disgust to the treatment procedure itself.
Sensitizing therapy method. Its purpose is to suppress the craving for alcohol and create conditions for the forced abstinence from alcohol. The patient is daily given the drug Antabuse (teturam), which in itself is harmless. However, when alcohol (even a small amount of beer, wine) enters the body, an interaction reaction occurs, the consequences of which can be very serious and unpredictable.
One of the options for this type of therapy is the creation of a drug depot in the body, for which an Esperal preparation is implanted subcutaneously or intramuscularly (usually in the gluteal region). Esperal is a 10 tablets, coated with a special coating, sealed in a sterile bottle. The reaction to the drug in the body occurs only in the case of alcohol consumption. Fatalities are possible. The patient is warned about the possible consequences of violation of sobriety, about which he gives a receipt, which, in turn, is a legal document for the doctor justifying his actions.
Psychotherapy is used from the first visit to a sick doctor and accompanies the entire treatment process. Explanatory psychotherapy is aimed at explaining the essence of the disease, its harm and harmful effects, the development of an orientation to treatment and a long sober lifestyle. The patient must understand that he is no longer able to drink “like everyone else” and that he cannot do without the help of a doctor. In addition to explanatory psychotherapy, other methods are also used.
Hypnotherapy (hypnosis) - suggestion in a state of hypnotic sleep. Indicated 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 techniques for which doctors have exclusive rights.
Group rational psychotherapy. For this type of treatment, a small group of patients (about 10 people) is selected, united by a community of psychological and social problems, which helps to establish emotional ties between them, feelings of mutual trust, and belonging to a special group. Patients discuss with the doctor and among themselves the most various life problems, primarily related to alcoholism. A joint discussion of various issues allows patients to look at themselves differently, evaluate their behavior. The special atmosphere of mutual respect and trust allows you to develop a certain lifestyle, with other (sober) attitudes and aspirations, to believe in yourself and your capabilities.
Remissions and relapses. After discharge from the hospital, the first 1-2 months, when you have to adapt to the new role of the teetotaler, are the most difficult for the patient. During this period, it is necessary to rehabilitate at work, to establish relationships in the family, to create a "legend" for their drinking buddies as an excuse for a sober lifestyle. Moral support in the family from friends and employees is a necessary condition for the establishment of high-quality remission.
Attraction to alcohol can persist for quite a long time, depending on the severity of the disease. It is usually accompanied by the same autonomic and mental disorders that were observed in a state of hangover. Therefore, a similar condition that occurs against the background of absolute sobriety is called pseudo-abstinence syndrome. The patient becomes irritable, agitated, “breaks down” on his wife and children, finds no place for himself. The doctor usually at discharge gives recommendations 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 see a doctor and, possibly, undergo a preventive course of treatment. The easiest way to avoid alcoholism: if you have a desire to "drink", you need to eat tight 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 agreed with the doctor.