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Here are three tests to help you decide if you have an addiction.
4. Have you ever used drugs to Ease withdrawal symptoms, or to avoid feeling low after using?
4. How often during the past year have you found that you drank more or for a longer time than you
intended?
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
5. How often during the past year have you failed to do what was normally expected of you because
of your drinking?
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
6. How often during the past year have you had a drink in the morning to get yourself going after a
heavy drinking session?
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
7. How often during the past year have you felt guilty or remorseful after drinking?
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
8. How often during the past year have you been unable to remember what happened the night
before because of your drinking?
Never (0)
Less than monthly (1)
Monthly (2)
Weekly (3)
Daily or almost daily (4)
References
1) Ewing, J.A., Detecting alcoholism. The CAGE questionnaire. JAMA, 1984. 252(14): p. 1905-7.
2) Babor, T.F., et al., AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for Use in
Primary Care. World Health Organization, Department of Mental Health and Substance Dependence.
http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf. WHO.
What is Addiction?
An addiction is a relationship with drugs or alcohol in which you use more than you would like to use,
and you continue to use despite negative consequences.
People use drugs or alcohol to escape, relax, or to reward themselves. But over time, drugs and
alcohol make you believe that you cant cope without them, or that you cant enjoy life without
using. The greatest damage is to your self-esteem.
You are ready to stop when the two sides of addiction collide. On the one hand, addiction feels so
good that you want to use more. On the other hand, addiction leads to negative consequences. After
a while, something has got to give.
You don't have to hit rock bottom. The purpose of websites like this is to show you the potential
negative consequences of addiction so that you will be ready to quit before you've lost everything.
You can imagine what it would be like to hit rock bottom. And that can help motivate you.
The most important consequences of addiction are social, emotional, and psychological.
People usually think of the physical and economic consequences of addiction. "I don't have a serious
addiction because my health is fine, and I haven't lost my job." But those are very late stage
consequences.
As far as work is concerned that's usually the last thing to suffer. You need your work in order to pay
your bills, so that you can continue your addiction. When your work begins to suffer, you've slipped
from being a functioning addict to a non-functioning addict.
The damage addiction does to your relationships and self-esteem is far deeper and takes longer to
repair. You've hurt friends and family. You've disappointed yourself. You've traded important things in
your life so that you could make more time to use. You've lived a double life. You've seen the hurt in
your family's eyes, and the disappointment in your children's faces. Those are the consequences that
can motivate you to begin recovery.
References
1) DSM stands for The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric
Association. ICD stands for The International Classification of Disease, published by the World Health Organization.
2) Mokdad, A. H., Marks, J. S., Stroup, D. F., &Gerberding, J. L., Actual causes of death in the United States, 2000.JAMA,
2004. 291(10): p. 1238-45.
3) Lowenfels, A. B., & Miller, T. T., Alcohol and trauma.Ann Emerg Med, 1984. 13(11): p. 1056-60.
4) Smith, G. S., Branas, C. C., & Miller, T. R., Fatal nontraffic injuries involving alcohol: A metaanalysis.Ann Emerg Med, 1999.
33(6): p. 659-68.
5) Roizen, J., Epidemiological issues in alcohol-related violence.Recent Dev Alcohol, 1997. 13: p. 7-40.
Addiction is due 50 percent to genetic predisposition and 50 percent to poor coping skills.
This has been confirmed by numerous studies. One study looked at 861 identical twin pairs and 653
fraternal (non-identical) twin pairs. When one identical twin was addicted to alcohol, the other twin
had a high probability of being addicted. But when one non-identical twin was addicted to alcohol,
the other twin did not necessarily have an addiction. Based on the differences between the identical
and non-identical twins, the study showed 50-60% of addiction is due to genetic factors.(1) Those
numbers have been confirmed by other studies.(2)
The children of addicts are 8 times more likely to develop an addiction. One study looked at
231 people who were diagnosed with drug or alcohol addiction, and compared them to 61 people
who did not have an addiction. Then it looked at the first-degree relatives (parents, siblings, or
children) of those people. It discovered that if a parent has a drug or alcohol addiction, the child had
an 8 times greater chance of developing an addiction.(3)
Why are there genes for addiction? We all have the genetic predisposition for addiction because
there is an evolutionary advantage to that. When an animal eats a certain food that it likes, there is
an advantage to associating pleasure with that food so that the animal will look for that food in the
future. In other words the potential for addiction is hardwired into our brain. Everyone has eaten too
much of their favorite food even though they knew it wasn't good for them.
Although everyone has the potential for addiction, some people are more predisposed to addiction
than others. Some people drink alcoholically from the beginning. Other people start out as a
moderate drinker and then become alcoholics later on. How does that happen?
Repeatedly abusing drugs or alcohol permanently rewires your brain. If you start out with a
low genetic predisposition for addiction, you can still end up with an addiction. If you repeatedly
abuse drugs or alcohol because of poor coping skills, then you'll permanently rewire your brain.
Every time you abuse alcohol, you'll strengthen the wiring associated with drinking, and you'll chase
that buzz even more. The more you chase the effect of alcohol, the greater your chance of
eventually developing an addiction.
Your genes are not your destiny. The 50% of addiction that is caused by poor coping skills is
where you can make a difference. Lots of people have come from addicted families but managed to
overcome their family history and live happy lives. You can use this opportunity to change your life.
(Reference: www.AddictionsAndRecovery.org)
and nobody would talk about it. Or they would make some quaint remark like, "Oh he drinks a little
too much." There was so little people could do about addiction before that there was no point in
talking about it.
But now that you can do something about addiction, a family history is worth talking about. Once
you stop using and tell your family that you're in recovery, that's often when they will tell you about
the family secrets. That's when family members will sometimes come out of the closet and tell you
their stories.
Let your coping skills be the legacy you pass on to your children. Don't let your genes be the
only legacy you pass on to your children. Your children are more likely to have an addiction because
of your addiction. But their genes don't have to be their destiny. You can help your children lead
happy lives by teaching them healthy coping skills by being an example with your recovery.
Is Addiction a Disease?
Addiction is like most major diseases. Consider heart disease, the leading cause of death in the
developed world. It's partly due to genes and partly due to poor life style choices such as bad diet,
lack of exercise, and smoking. The same is true for other common diseases like adult-onset
diabetes. Many forms of cancers are due to a combination of genes and life style. But if your doctor
said that you had diabetes or heart disease, you wouldn't think you were bad person. You would
think, "What can I do to overcome this disease?" That is how you should approach addiction.
Addiction is not a weakness. The fact that addiction crosses all socio-economic boundaries
confirms that addiction is a disease. People who don't know about addiction will tell you that you just
need to be stronger to control your use. But if that was true then only unsuccessful people or
unmotivated people would have an addiction, and yet 10% of high-functioning executives have an
addiction.
If you think of addiction as a weakness, you'll paint yourself into a corner that you can't get out of.
You'll focus on being stronger and trying to control your use, instead of treating addiction like a
disease and focusing on stopping your use.
Cross Addiction
You can become addicted to any drug, if you have a family history of addiction. If at least
one of your family members is addicted to alcohol, you have a greater chance of developing an
addiction to any other drug. Cross addiction occurs because all addictions work in the same part of
the brain. If your brain is wired so that you're predisposed to one addiction, then you're predisposed
to all addictions.
This is especially important for women who may come from alcoholic families, but who often develop
addictions that go undetected, like addictions to tranquilizers, pain relievers, or eating disorders.
One addiction can lead to other addictions, and one drug can make you relapse on another
drug. That's one of the consequences of a brain that's wired for addiction. Suppose you're addicted
to cocaine. If you want to stop using cocaine then you have to stop using all addictive drugs
including alcohol and marijuana. You may never have had a problem with either of them, but if you
continue to use alcohol or marijuana, even casually, they'll eventually lead you back to your drug of
choice. Recovery requires total abstinence.
How does cross addiction cause relapse:
1. All addictions work in the same part of the brain. Addiction is addiction is addiction. Therefore
one drug can lead you back to any other drug.
2. Even moderate drinking or smoking marijuana lowers your inhibitions, which makes it harder
for you to make the right choices.
3. If you stop using your drug of choice but continue to use alcohol or marijuana, you're saying
that you don't want to learn new coping skills and that you don't want to change your life.
You're saying that you want to continue to rely on drugs or alcohol to escape, relax, and
reward yourself. But if you don't learn those new skills, then you won't have changed, and
your addiction will catch up with you all over again.
(Reference: www.AddictionsAndRecovery.org)
References
1) Prescott, C. A., &Kendler, K. S., Genetic and environmental contributions to alcohol abuse and dependence in
a population-based sample of male twins.Am J Psychiatry, 1999.156(1): p. 34-40.
2) Enoch, M. A., & Goldman, D., The genetics of alcoholism and alcohol abuse.Curr Psychiatry Rep, 2001. 3(2):
p. 144-51.
3) Merikangas, K. R., Stolar, M., Stevens, D. E., Goulet, J., et al., Familial transmission of substance use
disorders.Arch Gen Psychiatry, 1998. 55(11): p. 973-9.
If you answer yes to three of these four questions, you are probably an alcoholic.
Do you have trouble saying no to alcohol sometimes? Do you drink more than you would like
to drink sometimes?
Do you sometimes feel guilt about how much you drank or what you did?
Are you concerned about your drinking? Have you ever wondered if you are an alcoholic? You
probably suspect the answer. But maybe youre afraid to admit it. This is your chance to do
something about it. Click here for a more detailed alcohol dependence test.
Is there a difference between alcoholism, alcohol dependence, and alcohol abuse? All these
terms mean the same thing in the DSM 5 (The Diagnostic Manual of the American Psychiatric
Association) and ICD-10 (International Classification of the World Health Organization). These names
have fallen in and out of favor over the years, in an effort to avoid negative associations, but they
are equivalent.
Table of Contents
Alcohol Withdrawal
Effects of Alcohol
Binge Drinking
Alcohol Poisoning
Treatment
Helping Someone with Alcoholism
You don't have to suffer major losses to have an addiction. Late stage alcoholism is the nonfunctioning alcoholic. By then you have lost your job and probably have to drink every day. It's what
people think alcoholism is like, but this stereotype is rare.
Alcoholism is progressive. The consequences get worse over time. It's never easy to quit. But if
you have already suffered some consequences and don't want them to get worse, there's never a
better time to quit than now.
Moderate drinking is no more than 1 drink per day for women and no more than 2 drinks per
day for men according to the US Department of Health and Human Services
The World Health Organization suggests no more than 2 drinks per day, and no more than 5
drinking days per week. They also suggest at least 2 non-drinking days per week.
For men, more than 4 drinks in a day, or more than 14 drinks per week.
For women, more than 3 drinks in a day, or more than 7 drinks per week.
People who drink more than the maximum limits are at high risk of becoming alcoholics. [2]
Approximately 60 percent of drinkers, drink less than 4 drinks on the days they drink.
Only 10 percent of drinkers, have 5 or more drinks more than half the days they drink.[3]
Alcohol Withdrawal
Alcohol withdrawal occurs because your brain works much like a spring. Alcohol is a brain
depressant that pushes down on the spring. When you suddenly stop drinking it is like taking the
weight off the spring. Your brain is out of balance. The spring rebounds and your brain produces
excess adrenaline which causes the withdrawal symptoms.
What goes on at the level of brain neurotransmitters? GABA is the calming neurotransmitter of
the brain. GABA and adrenaline are supposed to be in balance in the brain. Drinking regularly causes
the brain to produce less GABA, because the brain begins to rely on alcohol for part of the calming
effect. When you suddenly stop drinking, your brain chemistry is out of balance. You dont have
enough GABA neurotransmitter, and you have a relative excess of adrenaline, which causes all the
withdrawal symptoms.
h2>Alcohol Withdrawal Symptoms
These are some of the symptoms of alcohol withdrawal:
Anxiety
Irritability
Insomnia
Shaky hands
Sweating
Headache
Nausea/ Vomiting
Palpitations
Suddenly stopping alcohol can lead to seizures, strokes, or heart attacks in high risk
patients. A medically supervised detox can minimize your withdrawal symptoms and reduce the risk
of dangerous complications. Some of the dangerous symptoms of alcohol withdrawal are:
Heart attacks
Strokes
Hallucinations
How do liver enzyme tests work? The enzymes AST, ALT, and GGT normally occur inside liver
cells. If your liver is damaged, the enzymes escape into your blood stream and show up in your
blood test. Therefore the higher the enzyme count, the greater the liver damage. The most accurate
of these tests for alcoholic liver damage is GGT.
The second most common form of liver damage is fatty liver.
Some fat in the liver is normal. The liver is the main organ of fat metabolism in the body. But when
your liver is damaged by alcohol abuse fat begins to deposit in your liver. If fat makes up more than
5% - 10% of the liver, it is considered a fatty liver.
Fatty liver can be identified by blood tests and a liver ultrasound. This stage of liver damage is also
reversible with abstinence. However, fatty liver damage has a greater risk of turning into cirrhosis
with continued alcohol abuse.
Significant liver damage can cause jaundice. Jaundice means that your skin and/or the whites
of your eyes have turned yellow. This occurs when your liver can't remove a toxin called bilirubin
from your blood. Bilirubin is yellow, therefore when it builds up your skin and the whites of your eyes
turn yellow. Jaundice can be reversible if you stop drinking.
Alcoholic Cirrhosis
Repeated liver damage can cause cirrhosis. Your liver is a remarkable organ, but it can only
repair itself so many times. After a while your liver won't be able to repair itself and it will turn into
scar tissue. Cirrhosis is just the medical term that means part of your liver has turned into scar
tissue.
Reduced appetite
Weight loss
Swelling abdomen due to fluid accumulation (Your liver produces many of the proteins in your
blood. When it is damaged, fluid in your blood vessels gradually seeps out and accumulates in
your abdomen.)
Hepatic encephalopathy. A damaged liver has trouble removing toxins from your body. The
buildup of toxins can damage your brain, leading to changes in your mental state, behavior,
personality, and in severe cases, coma.
There is good news. Your liver is a big organ and you have more liver than you need. People can lose
30 percent of their liver in a car accident and still lead normal lives. So if you have less than 30
percent cirrhosis and you stop drinking, you can still lead a normal life. Your doctor can do an
ultrasound to see if you have cirrhosis, and estimate what percent of cirrhosis you may have.
Alcoholic Neuropathy
Nerve damage due to alcohol abuse is called alcoholic neuropathy. Alcohol is toxic to nerves
cells, which can cause brain damage and peripheral nerve damage. A significant part of alcoholic
neuropathy is also caused by the poor nutrition associated with alcoholism.
Alcoholic neuropathy usually has a reversible and irreversible component. The reversible
components is caused by the poor nutrition, and can be treated by thiamine (vitamin B1), folic acid,
and vitamin B12. The irreversible component is caused by the direct poisoning of nerve cells, and
there is no known cure. Up to half of long-term, heavy alcohol abusers develop alcoholic neuropathy.
Numbness or pins and needles (paresthesia) in the arms and legs. This usually occurs in the
hands and feet in what is called a stocking-glove distribution.
In severe cases, nerves that regulate internal body functions (autonomic nerves) may be
affected.
All studies show that there is no safe amount of alcohol during pregnancy. Alcohol is toxic to the
fetus and especially to the developing brain of the fetus. Drinking during pregnancy has a number of
effects including low birth weight and increased risk of premature birth. The main serious side effect
of drinking during pregnancy is fetal alcohol syndrome.
Fetal alcohol syndrome (FAS) and alcohol-related developmental disorders combined
occur in approximately one in 100 live births in the US and Great Britain. [11]
Some of the consequences of fetal alcohol syndrome include:
learning disabilities
depression
obsessive-compulsive disorder
Binge Drinking
Binge drinking is defined as five or more drinks per occasion for a man, or four or more
drinks for a woman, at least one day a month.
Heavy binge drinking is defined as that much alcohol at least 5 days a month.
Why is binge drinking so risky? Drinking four or five drinks over a few hours will raise your blood
alcohol concentration (BAC) quickly which makes you drunk quickly. Drinking the same amount over
several hours, and accompanied by food, will not have the same effect on your blood alcohol
concentration, and therefore will have less effect on your brain.
Approximately 12 percent of woman report having been sexually assaulted when either they or their
assailant had been drinking.[12] Binge drinking increases the risk of unprotected sex, sexual assault,
and sexually transmitted diseases.
Approximately one third of accidental deaths and one third of motor vehicle deaths are related to
alcohol abuse.[13]
Binge drinking increases the risk of academic problems, fights, motor vehicle accidents, physical and
sexual assault, and changes in brain development that may have long-term effects.
Binge drinking dramatically increases the risk of developing an addiction. College students
who drink more than 5 drinks, more than twice in two weeks are 19 times more likely to develop
alcoholism than non-binge drinkers.[14]
Note that a 750ml bottle of wine contains 5 drinks. Therefore 2 drinks a day is less than half a bottle
of wine a day.
The basic formula for calculating a drink is that each milliliter of pure alcohol weighs 0.79 grams.
Therefore, for example, 12 oz of beer or 330 ml of beer x 5% alcohol x 0.79 = 13 grams of pure
alcohol.
This information is provided as guideline only and should not be relied upon to determine if you can
safely operate a vehicle. Many factors can affect BAC, including the amount of alcohol consumed,
rate of consumption, food consumption, and factors such as gender, age, weight, height and
metabolism. However these numbers apply over a broad range of body weights.
It can take up to 30 minutes after the last drink to reach the maximum BAC level.
For men, 2 drinks or less in the first hour, and 3 drinks or less over three hours.
For women, 1 drink or less in the first hour, 2 drinks or less over three hours.
Alcohol Poisoning
Alcohol poisoning is a serious and potentially deadly consequence of drinking large amounts of
alcohol over a short period of time. If you suspect someone has alcohol poisoning, call for
emergency medical help right away.
There are many kinds of alcohol:
Ethyl alcohol is drinking alcohol. It can also be found in mouthwash, cooking extracts, and
medications in liquid form.
Isopropyl alcohol is found in rubbing alcohol, lotions, and some cleaning products. It is
more toxic than drinking alcohol.
Methanol (methyl alcohol) is used as an industrial solvent. It is very toxic and as little as
10 mL of pure methanol can cause permanent blindness.
Ethylene glycol is a common ingredient in antifreeze, air conditioning, paints, and solvents.
It is toxic to the central nervous system, heart, and kidneys. Because it has a sweet taste,
children are more inclined to consume large quantities of it.
Vomiting. This is the only symptom that can occur at lower blood alcohol levels. Alcohol
depresses the gag reflex and increases the risk of the person choking on their own vomit
(aspiration). Many famous and not-so-famous people have died this way.
Breathing, slow or irregular. In severe cases this can progress to stopping breathing.
Seizures.
Seek immediate medical care if you suspect the person has alcohol poisoning, even if you
don't see the classic symptoms.
If the person is unconscious, make sure they stay on their side, not their back, and turn
their head to the side to help prevent choking.
What Not To Do
Don't try to make the person vomit. Their gag reflex wont be working properly which
means they could choke on their vomit.
Don't leave an unconscious person alone to sleep it off. Again they may choke on their
own vomit.
AA Intergroup (aa-intergroup.org)
Reddit.com/Alcoholism (reddit.com/r/alcoholism)
Reddit.com/AlcoholicsAnonymous/ (reddit.com/r/alcoholicsanonymous)
Finding Treatment
Find an addiction specialist in your area: ASAM Addiction Medicine Treatment Finder
Find a substance abuse treatment facility: Substance Abuse Treatment Facility Locator
Please click here for a more detailed list of addiction and recovery resources.
Say that it is hard for you to raise the topic of their drinking, but you are concerned. You care
about them, and what their drinking is also doing to your family.
Try not to accuse or judge. Avoid name calling. This is a difficult time for both of you.
Allow the alcoholic time to go to meetings. Dont expect them stop drinking and stay sober
without help.
Understand that your lives will change. Do not wish for your old life back. You both need to
create a new life where it is easier to not use alcohol or drugs.
Make sure that you both have time for fun. People use alcohol to escape, relax, and reward
themselves. The alcoholic needs to find alternative ways to escape, relax, and reward
themselves otherwise they will turn back to their addiction.
Set boundaries that you all agree on. The goal of boundaries is to improve the health of the
whole family. Do not use boundaries to punish or shame.
If you want to provide financial support, buy the goods and services the person needs instead
of giving them money that they might use to buy alcohol.
Recognize and acknowledge the potential the person has within them.
What Not To Do
Don't punish, threaten, bribe, or preach to the person. It will only make them more
defensive.
Do not shield them from the consequences of their drinking. People are more likely to change
if they have suffered enough negative consequences.
Do not argue or try to discuss things with the person when they are under the influence. It
wont get you anywhere.
Practice loving detachment. What are your needs beyond the needs of the alcoholic? How can
you take care of yourself even when the other person does not take care of themselves? How
can you do that without feeling guilty and without being punitive?
Avoid self-blame. You cant control another persons decisions, and you cant force them to
change.
Do not work harder than the person youre trying to help. The best approach is to not do
things for the alcoholic, but instead to be an example of balance and self-care.
Being a caretaker is not good for you or for them. Understand that there is only so much you
can do.
Ask for help. Talk to a professional. Go to a support group such as Al-Anon. (More support
groups are listed below.)
If at all possible, try not to be negative when dealing with them. That may only increase their
feelings of guilt and push them further into drinking.
References
1) National Institute of Alcohol Abuse and Alcoholism, Helping Patients Who Drink Too Much: A
Clinicians Guide. 2005.
2) Dawson, D.A., B.F. Grant, and T.K. Li, Quantifying the risks associated with exceeding
recommended drinking limits. Alcohol ClinExp Res, 2005. 29(5): p. 902-8.
3) Dawson, D.A. and L.D. Archer, Relative frequency of heavy drinking and the risk of alcohol
dependence. Addiction, 1993. 88(11): p. 1509-18.
4) MacMahon, S., Alcohol consumption and hypertension. Hypertension, 1987. 9(2): p. 111-21.
5) Puddey, I.B., et al., Evidence for a direct effect of alcohol consumption on blood pressure in
normotensive men. A randomized controlled trial. Hypertension, 1985. 7(5): p. 707-13.
6) Bagnardi, V., et al., Alcohol consumption and the risk of cancer: a meta-analysis. Alcohol Res
Health, 2001. 25(4): p. 263-70.
7) Poschl, G. and H.K. Seitz, Alcohol and cancer. Alcohol Alcohol, 2004. 39(3): p. 155-65.
8) Seitz, H.K., et al., Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012.
Alcohol Alcohol, 2012. 47(3): p. 204-12.
9) Fergusson, D.M., J.M. Boden, and L.J. Horwood, Tests of causal links between alcohol abuse or
dependence and major depression. Arch Gen Psychiatry, 2009. 66(3): p. 260-6.
10) Schuckit, M.A., et al., Comparison of induced and independent major depressive disorders in
2,945 alcoholics. Am J Psychiatry, 1997.154(7): p. 948-57.
11) Sampson, P.D., et al., Incidence of fetal alcohol syndrome and prevalence of alcohol-related
neurodevelopmental disorder. Teratology, 1997. 56(5): p. 317-26.
12) Abbey, A., et al., Alcohol and sexual assault. Alcohol Res Health, 2001. 25(1): p. 43-51.
13) Hingson, R.W., et al., Age of drinking onset and unintentional injury involvement after drinking.
JAMA, 2000. 284(12): p. 1527-33.
14) Courtney, K.E. and J. Polich, Binge drinking in young adults: Data, definitions, and
determinants.Psychol Bull, 2009. 135(1): p. 142-56.
IMPORTANT: This is general medical information, and is not tailored to the needs of a specific
individual. This material is NOT complete. It does not cover all possible precautions, side effects, or
interactions. You should always consult your physician when making decisions about your health.
And you should consult your physician before starting or stopping medication.
I have no financial interest in Antabuse or any maker of Antabuse. I simply believe, based on the
medical evidence, that Antabuse increases the chances of recovery.
Numerous studies have proven that Antabuse is effective. It has been shown to reduce
cravings for alcohol (1), and to reduce the risk of relapse.(2, 3) It has also proven to reduce the risk
of relapse in adolescent addicts.(4)
People who use Antabuse feel liberated. That internal struggle that goes on every day, "Will I
drink? Won't I drink?" is silenced when you're on Antabuse. Because drinking is not an option you
don't waste your time thinking about drinking, and instead you focus more on your recovery.
Antabuse is effective, because you have to wait for one to two weeks before you can have a drink
after you stop Antabuse. You can't stop Antabuse one day and have a drink the next. It gives you
plenty of time to reconsider, restart your Antabuse, and ask for help.
Antabuse is a bridge between your two lives. On the one hand, you have the life that you know.
It's not what's good for you, but it's what you know. On the other hand, you have the life that you
want to get to. It's better for you, but you don't know how to live there. You don't know how to
relax, reward yourself, and celebrate without using drugs or alcohol. Antabuse helps you live in that
life long enough so that you can develop new habits and coping skills. (Reference:
www.AddictionsAndRecovery.org)
Headache
Racing heart
Dizziness
If you have one drink, you will vomit about as much as if you had food poisoning.
A few people are very sensitive to Antabuse and get a stronger reaction. A quick test of whether
you're sensitive to Antabuse is to see if your skin flushes when you put alcohol on your skin. If
you're sensitive you may still decide to use Antabuse, but you'll have to be a little more careful
about avoiding alcohol. Most people just need to show some common sense when they're on
Antabuse.
Side Effects
The side effects of Antabuse are less common than the side effects of relapse. During the
first week or two that you take Antabuse, you'll probably feel a little more tired. It usually lasts for a
week or two and then it goes away.
During the first two months that people take Antabuse, about 20% develop a funny taste in their
mouth. It's usually described as a metallic taste. 80% of people don't get it, and if you do get that
taste, it often goes away after a few weeks or months. That's it for the minor side effects of
Antabuse.
The major side effects of Antabuse are rare. The most common but still rare side effect of Antabuse
is liver damage. Any drug that you take over a long-term has the potential to cause liver damage.
With Antabuse, it happens in roughly one out of 30,000 people.
Your doctor can do a simple blood test to check the state of your liver before you start. After you've
been on Antabuse for a month you should have your liver tests repeated. Your doctor should
periodically check your liver enzymes while you're on Antabuse.
Any drug can have any possible side effect. You can never say never in medicine. Every year
people die from taking Tylenol (acetaminophen). But that doesn't mean we should stop using
Tylenol. The benefits far outweigh the risks. And the benefits of Antabuse outweigh the risks of
drinking.
Before taking Antabuse you should give your doctor your entire medical history. You may
not be a able to take Antabuse if you have a significant medical history of heart or blood vessel
disease, diabetes, an underactive thyroid, brain disorders (e.g., seizures, brain damage), kidney
disease, liver disease, a history of severe depression, a history of psychosis, or a history of suicide
attempts. Antabuse can alter the metabolism and blood levels of certain drugs, especially tricyclic
antidepressants, Dilantin (phenytoin), coumadin, isoniazid, and theophylline.
Do NOT take Antabuse if you're pregnant, or trying to become pregnant.
First, because you're worried about the side effects. Although the side effects of Antabuse can be
serious, they are rare. The side effects of relapsing on alcohol are common and serious.
The second reason is because you want to do your recovery on your own. You've always been selfreliant and you want to be self-reliant in your recovery. But recovery involves learning to ask for
help. Doing it on your own is overrated. You need to ask for help from your doctor, treatment
program, 12 step group, and sponsor. Antabuse is just one more thing you can use. It is not an
alternative to your supports. It complements them.
The third and final reason why you may be reluctant to try Antabuse is because you want
to leave the door open to having a drink. Just in case you want to relapse there won't be
anything in your way. Of course, if you leave that door open then it's guaranteed you'll relapse
eventually. It's just a matter of time.
If you've decided that you want to change your life. If you've decided that you have suffered enough
negative consequences, then I encourage you to talk to your doctor about Antabuse. (Reference:
www.AddictionsAndRecovery.org)
Getting a Prescription
Speak to your doctor about Antabuse. Antabuse is available at most pharmacies. If you are a
Canadian resident and your doctor cannot find a pharmacy that dispenses Antabuse, it can be
ordered through www.pharmacy.ca, which is an internet pharmacy that delivers free of charge
through Canada Post.
Anti-Alcohol Drugs
There are three anti-alcohol drugs available:
Antabuse (disulfiram)
Campral (acamprosate).
ReVia (naltrexone)
I have focused on Antabuse for a few reasons. It has a long track record, and is considered safe and
effective. It's available in generic form, which means that it's quite inexpensive. The cost of
Antabuse is a lot less than the price of alcohol.
Studies have shown that Antabuse is at least as effective, and sometime more effective than the
other two medications, which have only been around for a few years.(1, 5)
References
1) Petrakis, I., Ralevski, E., Nich, C., Levinson, C., et al., Naltrexone and disulfiram in patients with
alcohol dependence and current depression.J ClinPsychopharmacol, 2007. 27(2): p. 160-5.
2) Krampe, H., Stawicki, S., Wagner, T., Bartels, C., et al., Follow-up of 180 alcoholic patients for up
to 7 years after outpatient treatment: impact of alcohol deterrents on outcome.Alcohol ClinExp Res,
2006. 30(1): p. 86-95.
3) De Sousa, A., & De Sousa, A., A one-year pragmatic trial of naltrexone vs disulfiram in the
treatment of alcohol dependence.Alcohol Alcohol, 2004. 39(6): p. 528-31.
4) Niederhofer, H., &Staffen, W., Comparison of disulfiram and placebo in treatment of alcohol
dependence of adolescents.Drug Alcohol Rev, 2003. 22(3): p. 295-7.
5) de Sousa, A., & de Sousa, A., An open randomized study comparing disulfiram and acamprosate
in the treatment of alcohol dependence.Alcohol Alcohol, 2005. 40(6): p. 545-8.
Set a realistic goal for your alcohol use. Decide ahead of time how much and how often
you would like to drink.
Keep an honest journal of your drinking. This helps you become mindful of your drinking.
Start with a non-alcoholic drink to quench your thirst. When youre at a social event
make sure you have a non-alcoholic drink to start. Thirst can make you drink more alcohol
than you need. This also helps you become more mindful of your drinking.
Dont drink on an empty stomach. Make eating part of the experience. Hunger can also
make you drink more alcohol than you need.
Alternate alcoholic and non-alcoholic drinks. Don't have all your alcoholic drinks at once,
or you may be tempted to drink more than you planned. Instead have at least one glass of
water before each alcoholic drink.
Avoid heavy drinking situations. Some situations are associated with heavy drinking, and
it may be difficult to stick to your plan. Learn to recognize and avoid heavy drinking
situations.
The US guidelines suggest no more than 1 drink per day for women and no more than 2
drinks per day for men. A drink is defined as 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits.
The WHO guidelines suggest no more than 2 drinks per day, and no more than 5 drinking
days per week. They recommend 2 non-drinking days. Of course, you can't stockpile your
drinks, and have them all at the end of the week.
A drink is 14g of pure alcohol according to the US Department of Health and Human Services. The
World Health Organization defines a drink as 10g of pure alcohol.
Each milliliter of pure alcohol weighs 0.79 grams. Therefore, you can calculate the alcohol content of
a drink with the following formula:
1 can of beer (330 ml, 12 oz) at 5% (strength) x 0.79 (conversion factor) = 13 grams of
alcohol
1 glass of wine (140 ml, 5 oz) at 12% x 0.79 = 13.3 grams of alcohol
1 shot of liquor (40 ml, 1.5 oz) at 40% x 0.79 = 12.6 grams of alcohol
Note that a 750ml bottle of wine contains 5 drinks. Therefore 2 drinks a day is less than half a bottle
of wine a day.
Reference: www.AddictionsAndRecovery.org