Pharmacology and Alcoholism

Pharmacology and alcoholismPharmacology’s making it easier to stop drinking. As anyone familiar with alcoholism knows, getting alcohol out of the body is only the bare beginning. The reason alcoholics often return to drinking is due to the psychological obsession with alcohol, the ongoing craving for alcohol even after the body has been detoxified.

The alcoholic will crave alcohol long after detox, and this is why support groups like Alcoholics Anonymous are important. It also helps when the recovering alcoholic has support from family and friends, from a physician, and, often, from ongoing counseling. If the recovering alcoholic starts nutrition and exercise plans, both will help the recovering person get past the mental obsession. After a few months, the brain will heal and the recovering alcoholic will not longer crave alcohol — it could happen even earlier, as we’re all different.

Now, pharmacology might offer one more tool to the recovering alcoholic to assist in that early, difficult part of recovery. It’s a medicine that’s usually prescribed for asthma. Here is an excerpt from Medical Daily:

Giving up alcohol isn’t the hardest part of overcoming alcoholism — the subsequent cravings are what lead most to relapse. A new study from UCLA may have a way to better address these cravings. According to the research, a drug commonly used in Japan to treat asthma also has the unexpected side effect of quelling a desire for alcohol by reducing the pleasurable effects of drinking. The findings could one day make the drug a candidate for use in alcohol abuse treatments.

According to a study now published online in  Neuropsychopharmacology, the drug ibudilast significantly lowers user’s cravings for alcohol and helps to improve their mood when confronted with alcohol which they are not allowed to drink. In addition, the drug seems to alleviate user’s depression, a condition very common in heavy drinkers.

Recovering alcoholics need all the help they can get. Hopefully, this asthma medicine can be turned into an approved medicine for the treatment of alcoholism. It’s hard to describe the obsession with alcohol that tortures the alcoholic mind — it confounds loved ones, friends, employers and even medical professionals. It seems insane for a person to crave something that’s killing them, but this is the nature of alcoholism — now, hopefully, there’s more help to deal with this chronic brain disease.

The Damaged Alcoholic Mind

psycholical effects of alcoholismScience is learning more and more about the biological damage to the brain caused by alcoholism, and there are more and more medical treatments to help ameliorate the damage. The biological damage is the easiest to understand. The alcoholic mind is harder to understand. What’s difficult to deal with is the lingering psychological damage caused by alcoholism and past behaviors under the influence. This post is about alcoholism, but most of it pertains to addiction to other drugs such as opiates, cocaine, benzos, etc.

Once an alcoholic has been abstinent from alcohol for a period of time, the psychological damage is easier to assess. During active alcoholism and early withdrawal, alcoholics are often misdiagnosed psychologically. Alcoholism causes strange, irrational behavior (rational to the alcoholic, but irrational to others), and most alcoholics are anxious or depressed due to the consequences of alcoholism. The depression is also due to the fact that alcohol itself is a depressant.

The recovering alcoholic can experience intense, painful and persistent feelings of shame, fear, anger, depression, and any other feeling known to man. If these persistent emotions and states of mind are not dealt with, sobriety becomes an unbearable experience. If the painful, confusing, disorienting emotions and the uncomfortable states of mind are not dealt with, the recovering alcoholic is at risk for relapse. Most often, group therapy, counseling, support groups and behavior changes are enough for the painful emotions to subside, but if the depression or anxiety continues, a doctor who understands addiction should make appropriate recommendations — there might be a dual problem of alcoholism and depression or alcoholism and anxiety or alcoholism and some other mental health problem.

In treatment we help clients deal with their emotions and states of mind as they relate to alcoholism. Once the alcoholic (the drug addict of any sort) accepts their condition and understands that changes are necessary, the combination of talking therapy and a plan of action enables the person in recovery to perceive his/her reality as it is, and to begin changing that reality. If a person is going to change they must first acknowledge the starting point.

Often, the starting place is not pleasant, to say the least. The person in recovery doesn’t like admitting that they’ve hurt and alienated loved ones, wasted their savings, lost another job, have a DUI on their record, but reality is reality and nothing much can change if the person denies reality or blames other people, places or things. There’s a misunderstanding among much of the public regarding the disease concept of alcoholism — many people think that calling alcoholism a disease, which it is regardless of what the public thinks, is a cop-out and that it lets the alcoholic off the hook for responsibility. I hear non-alcoholics say all the time that no one poured the alcohol down the alcoholics throat. This is a simplistic way to perceive the problem.

What we do in treatment is educate our clients about the chronic brain disease of addiction, then the clients are responsible to do something about the problem and to answer for past behaviors. No one is getting off any hooks — in fact, it’s quite a rigorous and emotionally exhausting process dealing with past actions and the present consequences from years of irrational behavior and impaired judgement.

When the alcoholic understands the condition of alcoholism, then they can do something about the condition. If the alcoholic is simply condemned, berated and shamed, the problem only gets worse – if the person doesn’t understand that alcohol, and how alcohol affects their brain, is the main problem, they might try to do the right thing but continue to lose control of the alcohol and create more problems for themselves and others. The alcoholic who doesn’t understand his/her condition might stop drinking for awhile, start feeling better, straighten out problems, then think that they can drink responsibly again because they’ve become responsible and clear-headed. In fact, when family and friends tell someone in treatment that the disease concept is a cop-out and that the person only has to tighten up and control their drinking, they’re setting the person up to drink more and to continue the progression of alcoholism.

Recovering from alcoholism is difficult, but it’s worth the effort. Recovery requires abstinence, first of all. A recovering alcoholic has to understand their condition regardless of whether others understand or not. The reason Alcoholics Anonymous is so effective for long term treatment of alcoholism is that other recovering alcoholics understand what alcoholism and recovery are about. The average person, although they might have good intentions, doesn’t fully understand. The family member or friend can help, though, just by understanding they don’t understand.

AA and Recovery Management

recovery management

Alcoholics Anonymous

Understanding recovery management is a critical component of addiction treatment. Too many people who receive treatment for alcoholism or some other drug addiction believe they are “well” after 4 to 8 weeks of abstinence — they’ve gained insight about themselves and their addiction and they will take it from there, thank you.

Actually, treatment is just the beginning. Recovery from the chronic brain disease of addiction is an ongoing process. Recovery management means that the recovering addict takes a long term view of recovery. That initial feel-good experience after the first month or so has been called a “pink-cloud experience”. After years of doing damage to the brain and body, the person in early recovery starts eating better, sleeping better, taking care of themselves, and this produces a good over-all feeling that’s often mistaken for full recovery.

This pink-cloud experience doesn’t last. The psychological and spiritual damage done by years of addiction lingers even if the body begins to feel better. It takes a long time practicing recovery management before a person in recovery actually heals all the damage. The initial feeling that the addiction problem is under control is much like the person who goes on a crash diet and loses a few pounds then thinks they have the eating problem under control — the confidence fades when the going gets tough and the person slides back into old behavior and old ways of thinking.

Most people, if they’re not actively managing their recovery, slide back into what’s comfortable, because major change is difficult. This concept is also similar to an organization that calls in consultants to make changes in the organization to improve quality and outcomes — everyone starts out practicing the new ideas, but it’s difficult and uncomfortable, so they begin sliding back into old ways of doing things. It happens all the time. For the addict, though, sliding back means relapse, and relapse can cause a lot of damage — relapse can be fatal. With addiction, the active addict is always at high risk of premature death, so recovery management is very important.

This is why in treatment it’s suggested to a person in recovery that they attend a support group like Alcoholics Anonymous. AA and recovery management go hand in hand, although recovery management is also about exercise, nutrition, improving relationships, seeing a physician who understands recovery, etc. However, being around other people who have the same problem and are doing something about it for the long term reinforces the idea of recovery and change. When the going gets tough the group members can help a person through a hard time. Trying to make major changes alone is difficult, and, although family and friends may be supportive,  most people who haven’t gone through addiction really don’t understand addiction and recovery in a personal way and what it takes to manage the nuances of recovery. If AA is not right for person, there are other support groups that are effective. The person in recovery, as a part of recovery management, has to take responsibility for finding the right ongoing support and then utilizing that support.