Naltrexone VS Acamprosate: Which Drug to Combat Alcoholism and When?

When it comes to stopping drinking, many different circumstances exist. Maybe it’s time to quit drinking. Maybe you’re drinking too heavily too often and you want to cut it back to a normal level. Maybe you’ve been clean for some time but you’re having cravings for alcohol. These are three completely different circumstances, and each should be handled in its own way.

So where do you turn? Your most likely first step is to enter yourself into an alcohol abuse treatment program. During this process, it’s almost guaranteed that medication assisted treatment will be an option. Only three FDA-approved drugs exist to combat alcoholism: naltrexone, acamprosate, and disulfiram. However, in the medical field, much debate exists as to which drug to use and under what circumstance.

(Note: Disulfiram strictly causes the body to respond negatively to alcohol. Drinking with disulfiram in the system produces a multitude of hangover-like effects, and is only used as a physical deterrent. In different ways, both naltrexone and acamprosate are used to reduce craving, block the effects of drinking, and ultimately lead to abstinence or responsible drinking. Therefore, in this article, disulfiram is minimally focused on.)

Determining which Medication to Use

In 2013, UK-based Drug & Alcohol Findings (DAF) performed an analysis of forty years’ worth of scientific studies regarding the naltrexone/acamprosate debate. The results have just recently been published. What this means is the DAF research team reviewed countless studies on each drug, all performed between 1970 and 2009. The team sought to find “which is best in which circumstances and for which treatment goals.”

In this article, we will compare the alcohol-dependence medications naltrexone and acamprosate, in order to establish a knowledge base. Then we will review the findings of the DAF analysis, regarding which medication to use and under which circumstance. Finally, we will discuss the current use of both medications, some alternatives, and the best overall methods of alcohol treatment per circumstance.

What are Naltrexone and Acamprosate?

Naltrexone blocks opioid receptors in the brain. This causes the effects of opioids such as heroin or OxyContin to be prevented and/or reversed. Such drugs are called opioid antagonists. It turns out that opioid antagonists are excellent at decreasing alcohol consumption, as reinforced by an Oxford study. What’s more, naltrexone “is probably the most thoroughly scientifically established adjunct in the alcoholism treatment field,” as quoted from the study. Naltrexone is sold under the brand names of Revia, Depade, and Vivitrol.

Acamprosate essentially resets the chemical imbalances caused by problematic drinking. Among many other things, alcohol abuse leads to an overabundance of dopamine in the brain. Dopamine is a chemical produced by the brain that reinforces rewarding behavior, such as eating, exercising, or having sex, by creating feelings of joy. With prolonged alcohol abuse, the brain becomes used to extra dopamine, and eventually the drinker cannot feel that joy without alcohol.

This is the short story of what prolonged alcohol abuse does to your brain, and only one aspect of it. Multiple chemical imbalances occur in the brain because of alcohol abuse, and acamprosate can “restore the normal activity of glutaminergic neurons, which become hyperexcited as a result of chronic alcohol exposure,” according to the National Library of Medicine. Now, that’s a mouthful for laymen like yours truly, but basically this means acamprosate restores the balance of a pre-alcohol-soaked brain.

So, while naltrexone blocks the effects of alcohol and reduces the craving for it, acamprosate resets the brain’s balance and promotes abstinence from alcohol.

The Drug & Alcohol Findings Study

The question remains of which medication to use and when. The Drug & Alcohol Findings (DAF) study, linked again here, determined just that. First and foremost, the researchers tested each medication against a placebo. Both were found to work much better than the placebo, and therefore both are legitimate treatments for alcohol abuse. What they discovered next contradicted previous knowledge regarding naltrexone and acamprosate.

Previously, three major-scale studies had been performed to determine when to use which of the two drugs. The first study, in 2003, found little difference between them, giving naltrexone “a slight edge in delaying a return to drinking…,” as stated in the DAF study. The second study, in 2006, concluded both drugs to be virtually ineffective, finding “no significant effects of either medication compared with a placebo…” and the third study, also in ’06, determined naltrexone to be more effective when accompanied by psychosocial therapy, such as by a treatment facility. The opposite was found for acamprosate.

Obviously these conclusions are all very different. The DAF researchers believe they have once and for all determined a correct conclusion. According to their study, “naltrexone should be considered for patients who want less often to drink heavily, while acamprosate is better for those who seek abstinence.” Furthermore, both medications are more effective for those who are detoxified of alcohol.

Perhaps nothing revolutionary has been discovered here, due to the fact that both medications are fairly safe. However, the results of the DAF study help narrow down which path to take according to circumstances. The results will quicken the process of medication assisted treatment for alcohol abuse.

The Results for Naltrexone

Prior to the DAF study, it was commonly believed that naltrexone and acamprosate were nearly interchangeable. This is not so. Naltrexone benefits those seeking to cut back their current drinking, whether aiming for abstinence or not. Also believed before this study was that naltrexone can and even should be taken by patients who are still drinking. However, “required abstinence before treatment was associated with greater abstinence during treatment and greater reductions in heavy drinking.”

In further contrast to popular belief, the DAF study found that naltrexone is less effective as part of an alcohol abuse treatment program if abstinence is the main goal. In other words, if naltrexone is to be used as part of a treatment program, it is more effective when the program does not focus on abstaining from drinking.

The Results for Acamprosate

Before the DAF study, acamprosate was considered to be inferior to naltrexone. However, if a patient’s situation calls for complete abstinence as opposed to curbing drinking, acamprosate is preferred. Also, similarly to naltrexone, it is best if a patient is detoxified from alcohol when using acamprosate. “Both seem more effective when participants are detoxified and abstinent when treatment begins,” says the DAF study.

It was also noted that in the case of acamprosate, it’s possible “these requirements [of abstinence] filter out less committed and motivated drinkers, leaving a sample more likely to comply with treatment…” This is not the case with naltrexone, since it has for decades been given to patients who continue drinking alcohol regularly.

Regarding using acamprosate as part of an alcohol abuse treatment program, the results are the same as with naltrexone. No clear evidence was found to suggest that psychosocial therapy improves or worsens its effects. However, there is a slight lean toward psychosocial therapy actually weakening both medications’ effects. As stated in the DAF study, “…neither medication needs therapy to succeed,” adding that both medications may work better “when not overshadowed by effective psychosocial approaches.”

Current Uses (and their Necessary Updates)

The current status of naltrexone is best summarized by Dr. Stewart Leavitt of SAMHSA, or the Substance Abuse and Mental Health Services Administration: “In brief, naltrexone is significantly beneficial in helping those patients who cannot remain abstinent to reduce their drinking behaviors, breaking the vicious, self-destructive cycle in alcoholics whereby one drink leads to another, and allowing more quality time for psychosocial therapy to be productive.”

However, the DAF study has revealed that naltrexone may be more effective when separated from therapy, and is very likely to be more effective when used by a detoxified patient.

The current status of acamprosate is not as straightforward. It is widely believed that more research must be done on the medication. However, acamprosate is being used. According to an article by Dr. Bankole Johnson published on UpToDate, acamprosate is able “to reduce alcohol consumption compared with placebo in patients with alcohol dependence.” The major difference is how acamprosate achieves this. Yes, the drug seems to rebalance the brain’s chemicals post-alcohol abuse, but as written in the Substance Abuse Treatment Advisory published by SAMHSA, “Although acamprosate’s mechanism of action has not been clearly established, it may work by reducing symptoms of postacute (protracted) withdrawal, such as insomnia, anxiety, and restlessness.”

However, the DAF study shows that acamprosate “has a better record at promoting abstinence than naltrexone,” and is much less effective at reducing craving. As opposed to using acamprosate to reduce alcohol consumption, patients are better off using it once they are detoxified, in order to balance the brain. The medical community knows acamprosate does this, but still isn’t 100% clear how.

What this Suggests

As mentioned before, only three medications are FDA-approved for use in combating alcohol abuse. Aside from naltrexone and acamprosate, there is disulfiram, which if you remember is basically a physical deterrent from alcohol. If you have disulfiram in your system and you consume alcohol, a list of unpleasant things begins happening to you. Due to its blatant effects, disulfiram is a much simpler medication than naltrexone or acamprosate. The use of disulfiram is a common option, and is very different from the other two medications. Regarding naltrexone and acamprosate, what the DAF study truly uncovered was a paradox.

The study provided more specific uses than previously realized for the medications. Simultaneously, the study showed that “there is no evidence-based way to tell which drug will work best for an individual patient, or if any will help at all.” As a matter of fact, only “1 in 7 or 1 in 8 trial participants would not benefit more than when prescribed an inactive placebo.” This means there is good news and bad news. The good news is that there are now more effective ways to use naltrexone and acamprosate. The bad news is obvious. Utilizing medication assisted treatment may still be a bit of a guessing game for a while.

Just because the DAF study found psychosocial therapy ineffective when combined with medication does not mean the practice should be stopped. After all, in the words of the study itself, “Despite contrary findings… it remains possible that in terms of absolute improvements, supplementing medication with therapy will gain the best outcomes for a patient.”

The Best Choice for You

Frankly, what’s best for you is up to you. There are several options. Seeking entry into an addiction treatment facility is always your best bet. There, you have all of your options open to you. Medication assisted treatment or not, the help received through a recovery program is invaluable. That being said, what options are there regarding medication, and should you or shouldn’t you accompany them with therapy?

naltrexone-studies

The above chart is provided by Drug and Alcohol Findings as part of a series on Naltrexone. Although the most successful method is using both medications at once with no therapy, none of the methods fall below a 55% success rate. However it cannot be ignored that use of a placebo is the least successful method.

It boils down to a personal choice. Whichever method works best for you, stick to it. Some people might not require psychosocial or psychological therapies in order to sober up, but medication seems to help all recovering alcoholics.

The bottom line is that detoxification is an absolute requirement. Whether you aim for abstinence or responsible drinking, if you are abusing alcohol and want to stop, you must detox. If anything, the DAF study has reinforced this.

21st Century CURES Act Will Give $1 Billion to Fight Opioid Abuse

heroin-and-prescription-pill-addictionOn November 30th, the House of Representatives voted 392-26 in favor of a bill called the 21st Century Cures Act. Then five days later, the Senate voted 85-13 in favor. President Obama has already said he will sign it as soon as he can. Why such a rush? Because the Cures Act “could help unlock a cure for Alzheimer’s, end cancer as we know it, and help people seeking treatment for opioid addiction, said Obama in his most recent weekly address.

Mainly, the bill allows “the Food and Drug Administration [FDA] more discretion in the kinds of studies required to evaluate new devices and medicines for approval,” as written by NPR. This would speed up the process of FDA approval for certain drugs and medical devices. Also, the bill provides significant funding for the National Institutes of Health, as well as for researching cures for cancer, Alzheimer’s, and other serious illnesses.

Most importantly for the addiction recovery community, the bill provides $1 billion in funding to combat heroin/prescription pill abuse. “For nearly a year I’ve been calling for this investment so hundreds of thousands of Americans can get the treatment they need,” Obama said in the address.

What this Means for Opioid Addiction Recovery

The addiction recovery aspect of the Cures Act is very much an extension of the Comprehensive Addiction Recovery Act, or CARA, the single largest effort toward addiction recovery in our nation’s history. However, Obama requested $1.1 billion in funding for CARA and only $181 million was approved. With the passing of the 21st Century Cures Act, the original amount requested by the president is provided.

Regarding the Cures Act, Senator Amy Klobuchar of Minnesota “called the bill’s broad approach and widespread support ‘significant’ in a chamber often unable to act because of partisan gridlock,” as reported by her state’s Star Tribune. Klobuchar was one of the proponents of CARA, and she understands the opioid epidemic better than most. “As a former prosecutor, I have witnessed firsthand the devastation caused by opioid abuse in communities across the country. In Minnesota alone, overdose deaths rose by 11 percent in just one year,” Klobuchar said.

With a billion dollars in funding, the Cures Act promises more education and prevention efforts, expanded Narcan availability, resources to treat incarcerated individuals with addiction, disposal sites for unused prescription pills, and programs aimed directly at the heroin epidemic.

Some Opposition

It’s no wonder that just like CARA, the Cures Act was passed with flying colors. However, some government officials have criticized the 21st Century Cares Act.

The main argument against the act says that it financially benefits the drug industry and the medical device industry, but nobody else. The Los Angeles Times called the act “a huge deregulatory giveaway to the pharmaceutical and medical device industry…” adding that “nothing in the measure would address the main problem the public sees with the drug industry – inordinately high prices.”

Yes, the Cures Act will speed up the process for drugs and devices to get FDA approval, but with addiction and other diseases killing hundreds of thousands of Americans, something needs to be done. Surely the FDA won’t approve medicines or devices they see unfit, and this author for one trusts science.

Medication assisted treatment (MAT) is an enormous benefit for those battling opioid addiction, and with the Cures Act funding research with billions of dollars, some good must come of this. The advancements made possible by this act could turn out to save countless lives.

Six Alcohol Poisoning Deaths Daily in US

Forget about the thousands of deaths caused by drunken driving accidents. Forget about the discomfort and pain of delirium tremens, Alzheimer’s, cirrhosis, hepatitis, or fatty liver disease. Forget about the children born with fetal alcohol syndrome, which can be fatal in the worst cases. As terrible as these outcomes of alcohol abuse are, remember this: Alcohol is killing six Americans every day from alcohol poisoning, as reported by the Centers for Disease Control (CDC) last year.

Also, somewhat strangely, the overwhelming majority of alcohol poisoning deaths are occurring in adults aged 35 to 64. Even stranger, 7 out of every 10 people who die this way are NON-ADDICTS. This goes to prove how dangerous the substance alcohol is, let alone the risky behavior it causes and its addictive nature.

We as a nation are combating an alcohol (and drug) epidemic. In this article, the CDC report is summarized, as well as what alcohol poisoning actually is and how it can happen to anyone. The recent Surgeon General’s Report on Alcohol, Drugs, and Health, the first of its kind, is a major step along the way to reducing, eliminating, and eventually preventing unsafe alcohol (and drug) abuse.

The Facts

The CDC found there to be 2,200 alcohol poisoning deaths every year in the US, which averages out to 6.02 people per day. An overwhelming 75% of these deaths involve 35 to 64 year old adults. Those between 45 and 54 showed the highest alcohol poisoning death rate. This came as a shock to the researchers.

Ileana Arias, principal deputy director of the CDC, told US News in their article on the findings, “The majority of these deaths are not among college students, whom we typically associate with binge drinking. We were surprised.”  This goes to show that American adults are not only dealing with severe alcohol issues, they are not getting the help they need.

“Obviously we still have serious alcohol addictions around people in middle age that are unaddressed or untreated,” commented University of Pittsburgh professor of psychiatry Dr. Antoine Douaihy to US News. Obviously he’s right. Not only is that so, but due to recent changes in how alcohol poisoning deaths are calculated, government health officials believe the death rate to be higher than 6 a day.

In an effort to increase the overall health of Americans, the government issued Dietary Guidelines in 2010. According to the section regarding alcohol, “low risk” drinking is defined as “no more than 14 drinks a week for men and 7 drinks a week for women with no more than 4 drinks on any given day for men and 3 drinks a day for women.” Essentially, this is two drink daily for males and one drink daily for females.

Why Adults?

Apparently ignoring the guidelines, over 38 million American adults binge drink four times a month. During these binges, an average of eight drinks is consumed. In contrast, underage binge drinking (and drinking in general) is at its lowest since 1975, as found by the National Institutes of Health. Right now, fewer 15-24 year olds die from alcohol poisoning than those over 65. The consensus is that a combination of anti-alcohol efforts and programs, peer disapproval of alcohol, and difficulty to acquire all contribute to the decline in underage drinking. This graph from the CDC shows how alcohol use is lowest among schoolchildren and highest among the middle-aged:

alcohol-poisoning-deaths

David Jernigan directs the Center on Alcohol Marketing and Youth for the Johns Hopkins Bloomberg School of Public Health. According to Jernigan, another reason adults are three times more likely to die from alcohol poisoning is actually pretty simple. Younger people can tolerate higher amounts of alcohol, as they haven’t lived long enough to develop long-term physical issues. Plus they stay awake longer. The fact that alcohol poisoning deaths are lowest among young adults and highest among middle-aged adults proves this.

Common sense tells us there is a wide age range regarding drunk driving. A sixteen year old is just as likely as a 60 year old to crash a vehicle if intoxicated. There is also a wide age range regarding alcoholism, research shows. Someone can become alcohol-dependent at virtually any age. So, the fact that alcohol poisoning occurs mainly in middle-aged adults is a concern.

“When people think about alcohol, they tend to think about two problems: addiction and drinking and driving. This [the CDC report] shows there is another big problem – you can die from alcohol itself,” said Jernigan. So what exactly is alcohol poisoning?

Poisoned by Booze

Alcohol poisoning is medically defined as “a condition in which a toxic amount of alcohol has been consumed, usually in a short period of time. The affected individual may become extremely disoriented, unresponsive, or unconscious, with shallow breathing.” However, there truly is no clear-cut definition of alcohol poisoning, because alcohol is a poison.

Online news source Gizmodo interviewed an emergency room doctor about alcohol poisoning. (Because the doctor wished to remain anonymous, she is referred to in the article as Doctor L.) She explained how alcohol poisoning actually occurs with every single drink. The doctor said, “‘Alcohol poisoning’ is a layman’s term. Alcohol intoxication is a spectrum and there isn’t a specific threshold that one crosses and suddenly becomes poisoned.”

Every case is individual. All people respond to alcohol uniquely, and therefore no terms exist to define levels of alcohol poisoning. Obviously though, some cases are worse than others. Doctor L explained what an emergency room staff would do for a mild case of alcohol poisoning, and then for a severe case.

In a Mild Case

The doctor explained how mild alcohol poisoning is accompanied by dehydration, increased heart rate, and low blood pressure in some cases. Therefore, other than hooking an IV up to the patient, mostly the medical staff simply observes. “Often it is just a matter of watching the patient until he/she recovers. Intravenous fluids are often administered to help hydrate the patient…” said Doctor L. Victims of alcohol poisoning suffer from severe dehydration because alcohol is a diuretic, a substance which increases urination. Also, vomiting rids the body of water, furthering this dehydration.

A mild case of alcohol poisoning is no laughing matter. The term ‘mild’ is only being used here in comparison to a severe case, which can be fatal. The difference between a mild case and a severe case can literally be a drink or two. This is because someone can continue to drink even once diagnosable alcohol poisoning has set in.

In a Severe Case

Again, there are no clear levels of alcohol poisoning. However, with more severe cases of alcohol poisoning, victims are usually unconscious, unresponsive, vomiting, or any combination of the three. In severe cases, Doctor L said to Gizmodo, “the goal is to maintain adequate breathing and circulation until the body (mainly the liver) metabolizes the alcohol. It (alcohol) depresses the respiratory drive and may result in inadequate oxygen levels and/or excess carbon dioxide levels.” Patients are usually oxygenated.

Worse yet, alcohol causes failure of the gag reflex, greatly increasing the likelihood of choking to death on vomit. Preventing this used to be done by stomach pumping, but it has since been realized that pumping a stomach is more harmful than helpful. Nowadays, “a different, smaller tube is inserted through the mouth or nose, then threaded through the esophagus and into the stomach. The tube is placed on suction, which decompresses the stomach and greatly reduces the risk of vomiting,” said the doctor.

In any case, alcohol poisoning can be life-threatening. It is altogether dangerous, and a medical emergency in every case. A study performed two years ago by the CDC and multiple state health departments revealed that between 2006 and 2010, “9.8% of all deaths in the United States… were attributable to excessive drinking, and 69% of all AAD [alcohol-attributable deaths] involved working-age adults.” Furthermore, the study showed that in just those five years, a total of 2,560,290 years of life were taken away by excessive alcohol use. This is measured in YPLL, or years of potential life lost.

Not only is alcohol killing us, it’s giving us shorter lives.

What We’re Doing About It

In the recent CDC report regarding alcohol poisoning, (linked again here), three suggestions are given to both individual states and communities. Summarized, they are:

  1. Support alcohol awareness and prevention programs. The stronger the alcohol policy, the less binge drinking per state.
  2. Partner with law enforcement, medical personnel, health care providers, the addiction recovery community, etc. to help reduce excessive drinking
  3. “Monitor the role of alcohol in injuries and deaths.”

While practicing safe drinking is a strong recommendation, it’s rather apparent that Americans do not drink safely. Therefore, in addition to alcohol awareness and education, there needs to be a focus on treating those who already have alcohol issues.

The Affordable Care Act (ACA) of 2010 was enacted in order to increase the number of Americans with health insurance, and to keep the insurance at a reasonable cost. The act included a list of ten “essential health benefits.” In a beautiful stroke of luck for addicts seeking help, substance abuse disorders are one of them. Since January 1, 2014, “all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults… must include services for substance use disorders,” according to the Office of National Drug Control Policy.

While this was an essential step to be taken, the year 2014 had the most fatal drug and alcohol overdoses ever recorded in American history. In a well thought out response to this, Surgeon General Vivek Murthy made history recently by releasing the first-ever Surgeon General’s Report on Alcohol, Drugs, and Health (linked again here). In it, Murthy explains how two major things need to happen. The public image of addicts needs to shift from one of negativity to one of care and concern. Also, the healthcare system needs to incorporate drug and alcohol screening into routine medical visits for all patients.

The Surgeon General’s Report (and why we should all be screened)

surgeon-general-murthyMurthy believes the first step is for addicts to be treated like people with a disease, as opposed to like a criminal or an outcast. After all, addiction is indeed a disease of the brain. Once the societal outlook on addiction is similar to the outlook on any other disease, Murthy believes the next step is to integrate screening for substance abuse disorders into all doctor visits. Consider this section taken from the report itself, as there is simply no better way to phrase the screening argument:

Historically, our society has treated addiction and misuse of alcohol and drugs as symptoms of moral weakness or as a willful rejection of societal norms, and these problems have been addressed primarily through the criminal justice system. Our health care system has not given the same level of attention to substance use disorders as it has to other health concerns that affect similar numbers of people.

It is known that most people with substance use disorders do not seek treatment on their own, many because they do not believe they need it or they are not ready for it, and others because they are not aware that treatment exists or how to access it. But individuals with substance use disorders often do access the health care system for other reasons, including acute health problems like illness, injury, or overdose, as well as chronic health conditions such as HIV/AIDS, heart disease, or depression. Thus, screening for substance misuse and substance use disorders in diverse health care settings is the first step to identifying substance use problems and engaging patients in the appropriate level of care.”

In Conclusion

89% of drug/alcohol addicts receive zero treatment in their lives. The reasons for this are many, but seemingly screening for addiction routinely, in combination with addiction treatment being covered by insurance, would end the addiction crisis in America. One can only hope that these changes are made, and that they are effective.

The Dangers of Drunk Driving

Why would you drive drunk? You have to get somewhere? Okay, call a cab. Download the Uber app. Get a hold of a friend. Take a bus. Walk. Other options exist, none of which kill 27 people a day.

drunk-drivingDrunk Driving is the last thing you should do. Saying you’re a good drunk driver is like saying you’re good at potentially killing someone. Still feel you need some convincing? Read on and learn about the grueling statistics regarding drunk driving and about what drinking physically does to a driver of a vehicle.

A FATAL DECISION

Cold hard facts speak volumes where anecdotes and advice sometimes cannot. The following information is absolutely designed to scare you. Over 30,000 people have died as a result of drunk driving accidents in the last 3 years. An estimated 6,000 of these victims were children under 15. Over one person per hour DIES because of this epidemic. Over a million people have been injured due to drunk driving since 2014. One in three people will be involved in a drunk driving accident in their lifetime. One-third of these deaths and/or injuries are to the non-drunk person(s). Let’s put this all together:

Approximately 1,000 drunk driving accidents occur each day. Nearly 30 people die in these accidents, and over 300 of them aren’t even drunk. There is a 33% chance you will be injured in a drunk driving accident…even if you’ve never touched a drop. Please do not become a statistic.

NOT JUST DEADLY, ALSO ILLEGAL

dui-checkpointAs if bodily harm isn’t enough deterrence, consider the fact that nearly 1.5 million arrests of drunk drivers are made annually. The annual cost of this to the taxpayers exceeds $130 billion. Each year, more sobriety checkpoints are set up across the country, reducing the amount of drunk drivers by nearly 10%. Also, the number of arrests made increases with more checkpoints.

WHAT REALLY HAPPENS WHEN YOU DRINK AND DRIVE

‘One drink’ is defined as 12 oz. beer, or 5 oz. wine, or 1.5 oz. liquor. After just two drinks, judgement loss begins, a decline in visual function occurs, and the capacity for multitasking starts to fade. After three drinks, one experiences a lack of coordination, difficulty steering a vehicle, and much less alertness. After four drinks, concentration becomes difficult, there is reduced signal interpretation, (for example, stop signs and red lights are harder to see), and perception of speed is thrown off. After five drinks, steering is severely disabled, and braking becomes erratic. After 6 or more drinks, physical control is all but impossible, attention to driving becomes nil, and visual/auditory processing is quite impaired. Whether you’ve had one, two or twelve, do not drive a vehicle under the influence of alcohol or any other illicit substance.

HOW WE CAN PREVENT DRUNK DRIVING

Designate a sober driver. Do not let your loved ones drive drunk. If you have to get somewhere, call a taxi. Surely the fare is worth your (and others’) health. Also, on a non-personal level, the active enforcement of blood alcohol content laws, along with sobriety checkpoints and requiring mandatory alcohol abuse classes for DUI/DWI offenders, all are helping combat this problem. Just remember, if and when you decide to drive drunk, that you are deciding to put multiple lives at risk.

DRUNK DRIVING RESOURCES

Preventure, New Antidrug Program for Kids Proves Effective

It’s called Preventure, and it works.

Created by Patricia Conrod, professor of psychiatry at the University of Montreal, the new antidrug program for middle schoolers has been tested in Canada, Australia, Great Britain and the Netherlands. All studies published on the results show Preventure to be an effective program for reducing addiction risk in school kids.

By no means is Preventure the first of its kind. You may remember the DARE (Drug Abuse Resistance Education) program from middle school. You may even remember the infamous response from Nancy Reagan regarding peer pressure to use drugs: “Just say no!” Well, not only has Preventure shown itself to be far more effective than either the DARE program or just saying no, studies have also shown that the DARE program (and just saying no) doesn’t work at all.

Preventure works by assessing the children’s personalities, identifying the traits that make them most at risk for drug addiction, and then intervening in a sense, teaching the students “cognitive behavioral techniques to address specific emotional and behavioral problems,” and then encouraging them to utilize these techniques, as reported by the New York Times.

Let’s take a look at why DARE programs are ineffective, and then take a more detailed look at Preventure, how it works, and how effective it already has been.

Just Saying ‘No’ isn’t Good Enough

The adolescent drug education movement began in the early 1980s, essentially with the former first lady uttering her now-famous words in 1982. The next year, DARE was launched in Los Angeles. Since then, the DARE program, along with the notion of just saying no to drugs, has reached 75% of American school districts and has been used in 43 different countries. If the program is this popular, it must work really well, right?

Wrong.

The DARE program consists of uniformed officers lecturing groups of school kids on the dangers of drug and alcohol use, once a week, for about an hour at a time. While noble, a study published by the US National Library of Medicine shows how “the effects of the DARE program on drug use did not vary across the studies with a less than small overall effect.”

The problem is that DARE is strictly educational. While knowing drugs are bad is good knowledge, it doesn’t prepare you for real-world situations. Preventure creates social environments where factors contributing to the likelihood of drug abuse are targeted, discussed, and then dealt with in a healthy way. The Library of Medicine study goes on to say that “the DARE program is not successful in reducing drug use among children.”
What’s worse than DARE not working? DARE making kids more likely to abuse drugs. A 2002 study showed that the program and others like it may actually increase the likelihood of substance abuse in some participants. The study found that such educational drug resistance programs “resulted in greater increases in alcohol use, cigarette use, marijuana use and multiple drug use…”

Preventure, and why it is Good Enough

Professor Conrod’s adolescent antidrug program Preventure replaces the educational approach with a psychiatry-based social approach. Here’s how it works:

Before the school year begins, teachers take a 2 or 3-day crash course in methods of therapy proven effective against psychological issues. Then, participating children take a personality test at the beginning of the year. “Months later, two 90-minute workshops – framed as a way to channel your personality toward success – are offered to the whole school, with only a limited number of slots,” as said in the Times article.

This personality test has been shown to detect up to 90% of those students at risk for substance addiction. Preventure has narrowed their focus down to four traits thought of as showing risk for substance abuse: sensation-seeking, impulsiveness, anxiety sensitivity, and hopelessness.

The school seemingly selects students at random to attend the workshops, but in reality, only those students with extreme test scores are chosen to attend. Students are assigned to whichever workshop deals with their most prevalent traits. The workshops motivate the students to understand the connection between their personalities and real-world responses. This test-taking and follow-up workshopping continues through subsequent grade levels.

Cases Where Preventure has Worked

The first study to analyze this so-called “personality-targeted cognitive-behavioral intervention” was performed in 2009 and published in the Journal of Mental Health. The researchers set out to determine if programs such as Preventure could curb alcohol-related behaviors, namely depression, panic attacks, and/or truancy. Participants aged 13 to 16 were split between (an early form of) Preventure, and no intervention at all. Those in the intervention were assessed on the four previously mentioned traits.

The results were extremely positive for those in the program. The program was found to reduce depression, panic attack frequency, truancy, and even shoplifting. The researchers ultimately concluded that the “intervention effects indicate that personality-targeted interventions designed to prevent alcohol misuse, can concurrently reduce other relevant psychological problems in youth.”

This was the first step for Preventure. It was now proven that the program helps fight psychological problems. Since the core idea of Preventure is to address such issues, a study of Preventure in action needed to be performed.

The second study to analyze Preventure’s methods occurred three years ago in London, England. This time, the objective was to “assess the 2-year impact” of Preventure in 19 different schools. The teacher training occurred, where they learned about how to effectively help those with psychological issues. Then, the 90-minute workshops were held that each focused on 1 of the 4 trigger traits.

As before, it was determined that Preventure “can have a clinically significant impact on mental health outcomes in high-risk youth over 2 years,” but this time around it was also determined that Preventure can positively impact “personality-specific intervention effects in youth most at risk for a particular problem.” In plain English, this means Preventure works.

Another study performed in 2013 put the nail in the coffin, so to speak. Published in JAMA Psychiatry, the study placed 2,600 children aged 13 or 14, from 21 British schools, into Preventure. Finally, some hard data came.

Preventure was found to reduce drinking by 29% in the schools that participated. Furthermore, among those considered high-risk, binge drinking fell by 43%. Professor Conrod, founder of Preventure, said she believes even those who did not participate in this study were positively affected, receiving less peer pressure than normal from high-risk students.

The Four Traits

The four traits identified as putting kids at risk for addiction are the most important part of Preventure. Let’s dive a little deeper into these traits and why they are linked to being at risk for substance abuse.

Sensation-Seeking

This is the tendency to pursue excitement. While all of us like a thrill here or there, those who exhibit sensation-seeking behavior are those who put themselves at risk in order to experience excitement. Sensation-seeking people tend to be unpredictable, thrill-seeking, fun-loving people who enjoy the unfamiliar. As stated in the Times article, sensation-seeking “raises addiction risk for the obvious reason that people drawn to intense experience will probably like drugs.”

Impulsiveness

Defined as the inability to resist a certain action, impulsivity can lead to risky behaviors. Research has shown that those who regularly abuse substances exhibit signs of impulsiveness, and the more substances abused the more impulsive the abuser. Impulsiveness is also directly linked to Attention Deficit Hyperactivity Disorder (ADHD), and those with ADHD are three times more at risk to abuse substances.

Anxiety Sensitivity

A mouthful at nine syllables, anxiety sensitivity is defined as awareness and fear of the physical signs of anxiety. Think of it as the fear of fear. For example, worrying intensely about getting the shakes due to anxiety would be an example of high anxiety sensitivity. It’s almost like emotional hypochondria. Using drugs as a self-medication is common among those with high anxiety sensitivity.

Also, anxiety sensitivity is linked to panic attacks, which if you remember, are helped by the workshops of Preventure. It is also linked to Post-traumatic Stress Disorder (PTSD), and approximately 20% of those with PTSD suffer from a substance addiction. (The percentage jumps as high as 60% when dealing with veterans).

Hopelessness

There is no good reason to abuse drugs, but some reasons are worse than others. Perhaps the worst reason to abuse drugs is hopelessness. Not seeing any bright side to your own life or future can be devastating, especially for a school-aged child. Hopelessness can lead to depression, and approximately 20% of those with clinical depression also suffer from a substance addiction.

Conclusion (and More about Preventure)

Although Preventure has not yet been tested here in the United States, we sure could use it. By the time American students reach their senior year, half of them have tried an illicit drug and over 70% of them have been drunk. Over 10% of all alcohol consumed in America is consumed by the underage. No matter how you calculate the statistics, this country has a lot of drug-addicted children.

If DARE doesn’t work, then why are we using it in three-quarters of our schools? If Preventure works, why haven’t we heard of it until now? To truly fight the war on drugs, we must fight the war on drug-addicted children, stopping the problem at the source. Education is simply not enough, and being told to just say no might actually imply that it’s “cooler” to say yes, in order to be accepted.

To combat drug abuse among our youth, we need to implement Preventure, a socially-integrated and evidence-based means of fixing the problems behind drug addiction. This quote, published in Scientific American sums it up well:

“…substance abuse prevention programs often educate pupils regarding the perils of drug use, teach students social skills to resist peer pressure to experiment, and help young people feel that saying no is socially acceptable. All the approaches seem sensible on the surface, so policy makers, teachers and parents typically assume they work. Yet it turns out that approaches involving social interaction work better than the ones emphasizing education.”
Watch the introductory video to Preventure below.

If you are seeking to implement Preventure, click here for details regarding program training.

National Recovery Month – Still Running Strong

Since 1989, the Substance Abuse & Mental Health Services Administration (SAMHSA) has turned every September into National Recovery Month. All across the country, events are held that promote substance addiction recovery, as well as a sober and healthy lifestyle. Events include but are not limited to walks, runs, concerts, plays, movie nights, athletic challenges, conferences, and even 3,000 people joining hands across a bridge. The events are created by Planning Partners, who “help promote and plan National Recovery Month, disseminate materials, and sponsor events across the country.” These materials, including banners, flyers, and logos, are available free from the Recovery Month website.

 

Aside from events, National Recovery Month offers treatment support services, a TV and radio show called The Road to Recovery, awards for the best events, and a chance to share personal recovery stories. They are on Facebook, on Twitter as @RecoveryMonth, and even have a YouTube channel. While all of these things help promote and celebrate recovery, and help make it fun, National Recovery Month is really all about the events.

Events all over America

As we near the end of September 2016, the numbers are in for SAMHSA’s 27th annual National Recovery Month: 1,074 events, 23 published proclamations of support, and 2 more personal stories shared, adding to the several that already exist. These events are spread throughout the country, from Maine to California, with some even occurring in Puerto Rico. Every year, National Recovery Month has a different theme as well, this year’s being “Join the Voices for Recovery: Our Families, Our Stories, Our Recovery!”

National Recovery Month events are engaging, community-based, and maintain the spirit of sobriety. Events like the following can be critical steps in recovery. “Coloring the Canal” brought citizens of Indianapolis, Indiana together to color the downtown canal purple on September 1st. “Celebrate Recovery Movie Night” brought approximately 300 people together in various cities in Iowa to watch a movie and celebrate sobriety on September 8th. “Simposio la Recuperacion es Posible” gathered nearly 400 people in Trujillo Alto, Puerto Rico last week for a conference on responding to drug emergencies.

Tomorrow there is free Narcan training in Amityville, New York, and the say after there is Yoga for Recovery in Chattanooga, Tennessee. Click here for a complete event list.

Making a Difference

Well over 10,000 recovery programs and/or facilities actively participate in National Recovery Month. Since 1989, the program has made a major difference in the world of substance abuse recovery. Suzanne Somers used the program in 1991 to share with America her story of recovery. A study was conducted in 1996 by SAMHSA as part of National Recovery Month that focused on the level of impact drug and alcohol treatment has. This study was released by the White House. The list goes on.

In 1999, the TV and radio show was born, providing education on drug addiction and recovery from experts. Throughout all this time, internet activity had been increasing for National Recovery Month, and in 2003 they established their own website. Seven Major League Baseball games sponsored Recovery Month events in 2004, and the next year, Times Square in NYC aired a Recovery Month PSA. The number of national events went from 767 in 2007 to currently over 1,000.

The impact of National Recovery Month is best summed up by their mission statement:

Recovery Month promotes the societal benefits of prevention, treatment, and recovery for mental and substance use disorders, celebrates people in recovery, lauds the contributions of treatment and service providers, and promotes the message that recovery in all its forms is possible. Recovery Month spreads the positive message that behavioral health is essential to overall health, that prevention works, treatment is effective and people can and do recover.”

 

Alcoholism Among Law Enforcement Officers

People drink alcohol for several different reasons, but one of the top reasons is stress. The National Drug & Alcohol Rehab Directory named stress as the main reason people consume alcohol. A study isn’t even necessary to see how stress is a reason people drink. Haven’t you ever finished a hard day’s work and had a coworker exclaim it was time for the bar? Well, heading to the bar after work is especially common for police officers.

Not only do they have what is rated as the fourth most stressful occupation, studies show that over one third of police officers exhibit “one or more problem drinking behaviors.” Even more shocking, according to Police Chief Magazine, of all sources, one in four police officers have consumed alcohol on duty.

Why such high rates of alcoholism?

Research has indeed shown that stress and alcohol abuse are related. The occupational stressors police officers face are plentiful. From the obvious life-threatening aspect of the job, to the fact that police officers often face public adversity, there are many reasons officers get stressed. North Carolina Wesleyan College compiled a list of “stressors internal to the police organization,” and some of these include poor supervision, absence of promotion, excessive paperwork, and some actual police work stressors listed include fear, danger, and victim pain/anguish.

PTSD is also a major issue facing police officers, and research has determined that 42% of PTSD victims have an alcohol-related disorder.

On top of being an extremely stressful job, drinking alcohol is a social norm of police officers, much like the military. A social sub-culture exists wherein drinking is not only accepted; it is encouraged. Some studies have shown police officers to be among those hardest to reach by means of intervention, due to the almost frat-like relationship officers share.

What can be done to help?

It is no secret to the institution of law enforcement that alcoholism is a running issue among officers. According to Police One, “There is incredible amount of pressure constantly placed upon adults in social settings to drink alcohol — or else! When an adult — especially a male adult — requests a soda at a social gathering, it will often inspire someone within earshot to offhandedly jab something like, ‘Why don’t you get yourself a big boy drink.’”

While it is impossible to accurately measure the rate at which this adult peer pressure occurs, surely it happens too much. Among many other programs tailored for officers, many addiction centers offer recovery program options specifically for law enforcement officers.

Police officers are heroes, yes, but they are also susceptible to become substance abusers. Heck, 17.6 million Americans are alcoholics and there are about 765,000 police officers. The math adds up.

How to Live a Life in Recovery

For a recovering alcoholic or addict, learning to find balance can be particularly challenging. Leading a balanced life means avoiding extreme highs or lows. It also means paying attention to tendencies that many addicts have to focus or obsess too much on one activity, such as exercise or work. When the scales are tipped too far in one direction, it can trigger the urge to turn to mind-altering substances.

Running from feelings is what you’re used to, and since you know you can’t pick up a substance, you may try to run from your feelings in other ways. It’s not uncommon for a recovering addict to turn to overeating or gambling or relationship addiction. You may sleep too much or you might become obsessive about a hobby, such as working out. People turn to various forms of compulsive behavior when they don’t want to live in reality. As a recovering addict, you may tend to approach pretty much everything addictively. Some people miss the extreme highs and lows of active addiction. If you’re like many others in recovery, when you get sober, life seems … well, boring. Once you get through the initial rollercoaster ride of newly felt emotions, you may find yourself thinking, “is this all there is?” A sober life doesn’t have to be a boring life. How can you enjoy your life sober without intensifying all your experiences?

The Secret is Balance.

In order to continue on with your addiction recovery and balance your life you must have an idea of where it is that you want to go. Begin by setting a plan and then think about how to turn this into a vision. Having this plan will be the foundation for creating the life you want. For example, perhaps you want to be able to build a strong relationship with your children or begin a new career. You may not achieve this instantly, but this plan and vision will allow you to focus in on what you want.

Without a balanced lifestyle, it can be difficult to manage your stress levels and prevent yourself from falling back into addiction relapse. A common side effect of active substance abuse addiction is the lack of control experienced in the life of the addict.

In order to live a balanced lifestyle, you will generally need to change the types of habitual activities that you take part in your life. Examples of regular activities that would be beneficial for you to use as a replacement for former activities and to help strengthen your recovery are meditation, prayer, participation in therapy sessions and self-help groups and/or 12 step groups, as well as increasing your regular exercise schedule.

Finding natural balance is built on the physiologic operating principles of your nervous system. You can find and sustain a natural, resilient balance by following a carefully constructed program, a program of natural and common sense steps such as:

  • balanced sleep
  • the right amount of exercise
  • a structured diet of food and entertainment
  • healthy relationships
  • the right type of positive thinking or self-talk

Health and nutrition are critical in the recovery process and can increase your chance for long term sobriety.  The connection between the mind, body and spirit plays a critical role in reinventing yourself.

Alcoholism and drug addiction deprive the body of the essential vitamins and nourishment that your body needs to function properly.  Long periods of restricting and neglecting your diet causes an imbalance and can lead to serious gastrointestinal problems such as constipation, diarrhea, an inability to properly digest foods, as well as a suppressed appetite.

Learning how to properly nourish the body is an important and beneficial tool for your personal recovery.  Following a healthy diet can reduce cravings and decrease mood swings.  Eating properly teaches a recovering addict how to care for and respect their body.

What does a healthy diet consist of?

Balanced meals at regular times daily are extremely important for a person new in recovery.  Your diet should consist of foods with dietary fiber, complex carbohydrates, and protein.

Recovering individuals have a difficult time focusing, or concentrating on a particular thought or idea.  This is because drug use and alcoholism depletes dopamine levels in the brain. Eating foods high in protein can improve concentration and memory capacity.

Foods high in tyrosine, an amino acid used in synthesizing protein, are crucial for mental preparation.  Foods such as meats, poultry, seafood, and tofu are high in tyrosine.  These foods promote alertness and mental activity.

Healthy Nutrition Tips:

  • Caffeine and sugar can intensify mood swings, so reduce or eliminate both early in recovery
  • Consume different types of vegetables
  • Enjoy plenty of fruit
  • Eat wholegrain or sourdough breads
  • Use breakfast cereals that contain bran, oats and barley
  • Eat less starch, especially potatoes

Take a multi-vitamin. Recovering addicts lack many essential vitamins (find a supplement that includes: vitamins A and C, B-complex and zinc)

Establishing and maintaining a balanced diet, along with regular exercise and relaxation aid in restoring an addict to health. Exercise detoxifies, as well as strengthens the body and mind. When your heart rate is elevated your body release endorphins, which can reduce stress.

Drug abuse involves negative thinking and a distorted perception of reality, so changing these thoughts into healthy ones involves positive action. Physical activity focuses your energy and quiets urges to use drugs and alcohol.

When we are physically active we have more energy throughout the day, and our thoughts are more positive and optimistic.  We start feeling better about ourselves, which in turn creates positive thinking and an improved perception of ourselves.

The disease of addiction involves an obsession of the mind, so it is important to find a healthy balance in fixing both the mind and the body.  Individuals who are early in recovery should be careful not to focus too much on fixing the outside, as it is easy for a drug addict to transfer addictions.

Look at your recovery as a pie chart.  Consider the mind, body and soul as equal pieces of the pie.  Anytime one piece is too big or too small, it’s time to do something different.  Finding this balance will enhance your recovery and increase your overall well-being.

What Are the Physical Signs of Alcoholism?

When considering the signs of alcoholism, it’s important to remember that there is no single symptom that’s indicative of alcohol abuse or withdrawal. You must see the full picture and consider the all the symptoms of alcoholism that a person is experiencing.

The signs of alcoholism generally fall into two categories: behavioral and physical. In this article, we’ll explore the physical signs of alcoholism and alcohol dependence. Some of these physical symptoms of alcoholism can be fairly obvious and apparent, while others are fairly easy to conceal and may only be evident to the individual who is struggling with alcoholism.

Physical Signs of Alcoholism – General Appearance

Alcoholism can have a significant impact on an individual’s overall appearance. Personal hygiene often suffers, as the person may not shower regularly. They may also lack the motivation to tend to their hair or makeup.

With an individual who drinks heavily on a daily basis, you may notice that they look perpetually unwell, with a poor skin complexion, dark under eye circles and a tired demeanor. Chronic dehydration, combined with poor sleep, is a major contributor to an individual’s sometimes haggard appearance.

Weight gain, particularly around the midsection, is also commonplace. This can occur due to a lack of exercise, combined with poor food selection while intoxicated and high-calorie drinks, such as beer.

When alcohol is withheld, the individual may get very distressed, ultimately exhibiting signs of a condition known as alcohol withdrawal syndrome (AWS). Symptoms can include anxiety and irritability, unsteadiness, seizures or tremors, sweating, fever, nausea, vomiting, insomnia and even hallucinations.

One of the most severe signs of alcoholism is called Delirium Tremens (DT), symptoms include:

  • Severe Agitation or Confusion
  • Fever
  • Sweating
  • Seizures
  • Headache
  • Convulsions and Tremors
  • Tactile Hallucinations of Itching, Burning or Numbness
  • Auditory Hallucinations
  • Visual Hallucinations

If you or a loved one are experiencing these symptoms, it’s best to seek immediate medical attention by calling 911 or by going to the nearest emergency room for treatment.

Physical Signs of Alcoholism – Skin

Alcohol impacts virtually every body system, so the physical symptoms of alcohol abuse can be observed throughout the body as well. This includes the skin.

Jaundice / Yellow Skin Tone

Jaundice is one of the more obvious signs of the liver problems that commonly accompany alcoholism. Jaundice occurs when the body fails to metabolize bilirubin, which is yellowish brown in color. Bilirubin forms as the liver breaks down old blood cells, but fails to metabolize and process those bilirubin particles. In a healthy person, the liver breaks down bilirubin, which is then excreted when the person has a bowel movement. But in a person with liver disease or another condition that impacts liver function, the bilirubin levels rise to abnormally high levels, giving the skin a yellow color. The whites of the eyes will also appear yellow in many individuals.

In addition to jaundice, it’s common to observe other signs of liver disease, such as nausea, vomiting, weight loss and a generally poor physical condition.

Poor Skin Condition

It’s not uncommon for men and women to experience poor skin condition or chronic breakouts due to poor hygiene. Some women have a tendency of passing out or falling asleep while still wearing makeup. Forgetting to wash your face before going to bed can certainly contribute to skin problems.

Additionally, the body’s immune system is heavily taxed by frequent alcohol consumption, resulting in a much higher frequency of skin infections, including pimples, cysts, sores and abscesses.

You may also observe a persistent redness on the nose and cheeks, resulting from alcoholism-related changes in the circulatory system.

Spider Angiomas

One of the more common physical symptoms of long-term alcoholism involves the formation of spider angiomas (also called a spider nevus), which are small spider web-like marks on the skin. They can be red or blue/purple in color. They’re most commonly found on the nose and cheeks, but can arise elsewhere on the body too.

Spider angiomas often form as the result of liver disease and cirrhosis of the liver. Liver disease and cirrhosis can both arise from long-term alcohol abuse. It’s important to remember, though, that liver issues and spider angiomas can occur in individuals with non-alcohol-related health issues too. For instance, spider angiomas can result spontaneously or due to high estrogen levels (which is common during pregnancy.) So alone, they are not necessarily indicative of alcoholism. But you may have cause for concern if you see these vascular formations in conjunction with other symptoms of alcohol abuse.

Bruises and Injuries

Alcohol skews your equilibrium and balance, resulting in bumps, bruises and even more serious cuts and injuries.

An individual with an alcohol problem may have bruises and other injuries on a fairly frequent basis – far more frequently than the average person.

Physical Signs of Alcoholism – Liver Problems

Alcohol abuse is a common cause of liver problems, as this vital organ serves as a filter of sorts (amongst other functions). Alcohol-related liver disease or ARLD can be life-threatening, even in a younger individual. In other words, you do not need to drink heavily for 30 years to get liver disease.

The liver does have the unique ability to regenerate. So it is possible for the liver to heal in many – but not all – cases. This requires time and sobriety. It’s also important to note that moderate to severe scarring (such as that associated with cirrhosis) is typically permanent. But seeking treatment can lead to a dramatic improvement in your condition.

There are three basic phases to ARLD. They are as follows:

Alcoholic Fatty Liver Disease

This is the first and least severe stage of alcohol-related liver disease. With this condition, fat accumulates in and on the liver. This causes inflammation, mild scarring and fat deposits that impair the liver’s ability to function properly.

Often, there are no noticeable symptoms of alcoholic fatty liver disease. In other cases, a person may experience weakness, fatigue and abdominal pain in the upper right area of the abdomen. Lab work may reveal elevated liver enzyme levels, but this is not always the case. Liver function could appear normal according to diagnostic tests.

Fortunately, you can typically reverse the effects of alcoholic fatty liver disease by abstaining from alcohol and medications that place a strain on the liver.

Alcoholic Hepatitis

Alcoholic hepatitis occurs in about one-third of all heavy drinkers, making it a fairly common condition. Alcoholic hepatitis can occur on a broad spectrum, from mild (with no apparent symptoms) to severe and even life-threatening.

Alcoholic hepatitis arises when large quantities of fat are deposited in the liver, leading to inflammation and scarring. With this condition, lab work will reveal a significant elevation in liver enzymes and liver function tests typically reveal some degree of impairment.

Symptoms of alcoholic hepatitis include fever, abdominal pain, nausea, vomiting, jaundice and poor appetite.

In the early stages of alcoholic hepatitis, the effects on the liver are often reversible. But by the time an individual reaches the late stages or suffers from a bout of acute alcoholic hepatitis, much of the scarring and damage to the liver is permanent. Acute alcoholic hepatitis can ultimately lead to death from liver failure.

Alcoholic Cirrhosis

Alcoholic cirrhosis is a very serious and life-threatening condition. It is the most advanced stage of alcohol-related liver disease (ARLD). It’s estimated that as many as one-quarter of all heavy drinkers (and an even larger percentage of those who struggle with an alcohol addiction) have cirrhosis of the liver.

Cirrhosis occurs when the liver suffers extensive and severe scarring. Normally, the liver tissue is soft and flexible, but when scarring occurs, that soft tissue is replaced with hard, inflexible scar tissue. This has an adverse impact on the liver’s ability to function. The end result is liver failure.

While cirrhosis is not reversible, the patient can still enjoy benefits from enrolling in an alcohol treatment program. This is because the symptoms of cirrhosis and ARLD will improve – sometimes dramatically – and abstinence can prevent further damage and worsening of one’s health condition.

Abstinence will also reduce the chances of developing further complications, such as liver cancer. Individuals with another liver ailment, such as chronic hepatitis C, are at especially high risk of developing health problems that could ultimately necessitate a liver transplant.

Other Physical Signs of Alcoholism – Sleep Patterns

Alcoholism can result in some very abnormal sleep patterns, which may be very noticeable to a spouse, family members and even your friends or employer. These abnormal sleep patterns can, in turn, impact your health in numerous ways.

In fact, even just a single drink before going to bed can actually do more harm than good.

After consuming alcohol, the body will fall into a very deep sleep. This is actually unhealthy, as sleep occurs in cycles. The first stage in that cycle is called rapid eye movement sleep or REM sleep. When you drink, your body skips the REM sleep cycle (or goes through this stage very briefly). The result: you fall into a very deep sleep and you may be difficult to rouse.

Scientists and researchers actually have very limited knowledge about what actually happens while we sleep; in fact, science isn’t entirely sure why the body even needs sleep in the first place! But anecdotal evidence tells us that this REM stage of the sleep cycle is critical for feeling refreshed and rested. Studies have revealed that in an average night, a healthy person experiences approximately six to eight bouts of REM sleep. A person who has consumed one or more drinks before going to bed may experience just one or two bouts of REM sleep throughout the course of the night. The result is that you wake up feeling as though you haven’t slept a wink. Also, since you experience long periods of deep sleep after drinking, there is a greater chance that you’ll sleep through your alarm.

Sleep pattern disturbances are also common in alcohol abusers who are trying to cut back on their drinking. Insomnia is one of the many symptoms of alcohol withdrawal syndrome. But beyond this, there’s also a psychological component. Virtually every individual who struggles with alcohol dependence drinks to escape some uncomfortable reality. This could be a past trauma, depression, anxiety or any number of challenges that one may encounter in life. These issues can make it challenging to quiet the mind and fall asleep.

Other Physical Signs of Alcoholism

The physical signs of alcoholism are numerous and quite varied.

Amongst the signs of alcoholism are redness and/or swelling involving the palms of the hand. The individual may also experience numbness, tingling or a lack of coordination in their hands and even in their feet. This can also result in unsteadiness.

In addition, alcohol-related liver disease can cause a number of other symptoms, such as ascites, which is an accumulation of fluid in the abdominal cavity. It’s also possible to develop complications such as an enlarged spleen or kidney failure.

Frequent exposure to alcohol can cause damage to the esophagus (throat) and stomach. The harsh nature of alcohol (especially hard liquor) can irritate the sensitive tissues in these areas of the body. This may lead to the formation of an ulcer, which is essentially an internal sore.

Ulcers have a tendency of bleeding when irritated, causing pain, discomfort and even further stomach upset due to the blood. This frequently results in chronic nausea, vomiting and decreased appetite.

While most people associate alcoholism with weight gain, but weight loss is also a fairly common sign in individuals who are in the more advanced stages of alcohol abuse. As liver function becomes more and more impaired, it’s typical to see some fairly significant and rapid weight loss

Alcohol abuse is a very complex issue, with many physical, psychological and behavioral signs and symptoms. If you or a loved one are struggling with alcoholism, there is help. You don’t need to go through this process alone. Speak to an addiction treatment counselor that is committed to providing a comprehensive range of treatment solutions for people who are struggling with alcoholism.

Children of Alcoholics: The Effects & Coping with the Stress

Being the children of alcoholics, (a COA), can be extremely stressful. Your parent(s) may get angry a lot, may threaten you, may forget lots of things, and may even abuse you. The important thing to know is that there is help, and that you are not alone. We will discuss some of the possible effects of being the child of an alcoholic, as well as some methods for coping with the stress it brings.

Approximately 18.25 million people are children of alcoholics, and these children are 4 times as likely to become addicted than children of non-addicts. Every second, two babies are born to addicted parents. One last fact: 43% of adults have been exposed to alcoholism in their lives. Alcoholism is a pervasive disease and understanding what having alcoholic parents means and how to deal with it is crucial.

Effects of Being Children of Alcoholics

Children of alcoholics are at higher risk than others for emotional issues. Obviously everyone will have his or her own personal experience, but there are some common effects of being a COA. Shame is commonly felt, especially if the child is hiding the parental alcoholism. The child may feel embarrassed of the parents, and this may cause the child to lie or even develop a story to explain it. Guilt is also commonly felt by children of alcoholics, but it is very important to realize and remember that it is not the child’s fault, regardless of what may be said.

Other effects of having alcoholic parents include feeling angry, feeling depressed, falling behind on schoolwork, feeling stressed, and feeling alone/reclusive. These emotions are unhealthy but justified. If you are the children of alcoholics and you feel any of these things, do not blame yourself. You are not meant to carry this on your own.

How to Deal with Alcoholic Parents

If possible, talk to your parents. Let them know how you’re feeling. An alcoholic trapped in the depths of the addiction may not even realize what they’re doing to their loved ones. Maybe even encourage them to not drink or to drink less. If it’s not possible to talk to them, try talking to a friend or to a counselor. Most schools offer counseling, and there are also plenty of support groups available. Al-Anon is an organization that helps the family and friends of alcoholics “find understanding and support” through meetings. A branch of Al-Anon known as Alateen is designed specifically for children of alcoholics.

Sometimes alcoholic parents can be so harsh that more than talking is required. If you are being abused, get out. Call 911 or someone you know and love that can help you. Even threats of abuse are taken very seriously. That being said, if talking simply won’t work, and your parents are not a threat to you, get out of the house. From moving in with a different relative to joining a club, the less time you spend at home right now, the better.

It’s up to the parent.

The bottom line is that it’s on the parent or parents to curb their drinking and get the help they need. You can talk with them, cope with them, beg them and cry, but until they want to stop drinking, they won’t. Talk to them. Talk to friends and other family. Talk to counselors. Even host an intervention, if need be. The goal is to get your parents to understand what their alcoholism is doing to the family.

For young children of alcoholics, click here for a do-and-don’t list regarding coping. For some helpful tips on dealing with alcoholic parents, click here.