If you can say yes to two or more of the following statements (that both happened within a single 12 month period) then you have alcohol use disorder:
1. Alcohol is taken in larger amounts or over a longer period of time than you planned.
2. There is a persistent desire or unsuccessful efforts to cut down or control how much you drink.
3. A great deal of time is spent in finding alcohol, drinking it, or recovering from its effects.
4. Craving, or a strong desire to drink.
5. Recurrent alcohol use resulting in failure to fulfill major role obligations at work, school or home.
6. Continued drinking despite having persistent or recurrent social or interpersonal problems caused or worsened by the effects of alcohol.
7. Important social, occupational or recreational activities are given up or reduced because of alcohol use.
8. Recurrent alcohol use in situations where it is physically hazardous.
9. Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or made worse by alcohol.
10. Tolerance - needing more alcohol to get the same effect or less effect felt with continued use of the same amount of alcohol.
11. Withdrawal - having symptoms of withdrawal when not drinking or needing to use alcohol or something similar to avoid withdrawal symptoms
Medically, three medications are approved for alcohol use disorder in Canada. Naltrexone, acamprosate, and disulfiram.
Social treatments include 12-step approaches such as Alcoholics Anonymous, Celebrate Recovery, or Secular Sobriety. Counseling can also be very helpful for many people to help recognize your triggers for drinking, and how to avoid them or deal with them when they come up.
This is an excellent video from David Suzuki and the CBC on alcohol use disorder and its treatments and experience.
Naltrexone is a an opioid antagonist that decreases alcohol craving and leads to less heavy drinking days by reducing euphoria. Side effects are generally mild and short lived and include headaches, stomach upset, and dizziness. You should not use this if you are using or dependent on chronic opioids or if you are pregnant.
Acamprosate is an amino acid derivative that increases GABA neurotransmission and has complex effects on glutamate transmission in the brain. It decreases the frequency and quantity of drinking. You need to be abstinent for a few days first for it to work. The side effects are mild and short lived and include feeling itchy and stomach upset. You should not use this if you are pregnant or if you have renal disease.
Disulfiram is probably best known by its old trade name "Antabuse". This medication can only be accessed through a compounding pharmacy as it is not sold as a pill anymore. It works by turning off an enzyme that breaks down alcohol products. It results in build up of acetaldehyde if you drink alcohol. The acetaldehyde makes you very sick if you drink. It also has many side effects, such as drowsiness, and rarely liver toxicity and nerve damage. It really works best for for very motivated individuals with a strong support system providing their medication daily under supervision.
If you are dependent on alcohol to the point where you experience withdrawal symptoms such as tremors, hallucinations, or seizures, you will need to have some medical assistance with "detoxification". This may need to be done in a medical facility depending on your other medical issues, or it can be done at home if you have enough supports and are able to come in regularly during the process.
This will depend on a lot of things - including how each medication makes you feel, as well as how you pay for your medication, and what other health issues you have.
We have partnered with Addictions and Mental Health Hastings Prince Edward to provide counseling on Tuesday mornings as well.
Please come to the rapid access addiction medicine clinic hours Tuesdays from 830-12 and 1-5 PM for an intake visit, or call to see if you can come at a different time.
If you are not in the area, but a different part of Ontario, please go to the Drug and Alcohol Helpline (1-800-565-8603) to connect with programs and services in your area.
Alcohol use disorder treatment using naltrexone.
Copyright © 2018 Dr. Melissa Holowaty - All Rights Reserved.
The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites.