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Suggest Treatment For Alcohol Dependence

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Posted on Sat, 4 Oct 2014
Question: Dear Sir,

My husband is having alcohol from 12 years. When i got married he came home and fight with me on various family reasons, slowly i found that he behaved like an abnormal person. He get violent on me but now our problem increased. His behaviour is violent to all other family members. he has lost her sense . and in evening he search reasons to go out of the home. He is in real estate by profession. He found many reasons for drinking, sometime family issue, seasons, some professional parties.

He started shouting, behaving violently after coming home. Sometime he drinks at evening also.

As per him he is not a drinker. he drinks only to make his mood light. But after drinking 2 pags only he lost his sense and started behaving abnormal.

When i ask him to consult a doctor , he got more furious and behave like a mad person on me.

He never like to have drink at home. he drink at his office or a lonely place. he even sometime drink without his friends.

Most of the time he drink with his group of Dealers.

What can i do for him or my family? His age is now 39 .

Please suggest some medicine doctor , which i can provide him without his knowledge and he stop drinking.
doctor
Answered by Dr. Sunil Gupta (1 hour later)
Brief Answer:
Please see details below.

Detailed Answer:
Dear Mrs. XXXXXXX

I went through your query in detail and can understand what you must be going through. Being with person who gets violent after drinking and moreover, not ready to accept the problem is really traumatic and you must be going through a lot.

Let us first see regarding the medical treatment of alcohol dependence. There are two types of medications. The first group includes anti craving drugs like naltrexone, acamprosate, topiramatem, baclofen. These medications help in reducing the craving for alcohol. These medications however, work better only if the patient himself wants to quit drinking.

The other medication is termed aversive drug and includes Disulfiram. It cause adverse reactions if a person drinks alcohol together with the medication and as a result of which he starts avoiding alcohol. However, if given without the knowledge of the patient, it may even cause fatal reaction and hence is never recommended without obtaining the patient's consent.

Personally, I would not advise any drug to be given without his knowledge. It is important to make him realize that he has problem drinking and he needs to quit. You can also ask your family members and friends to intervene since you yourself have not been successful doing that.

Another way out will be to tag him along to a psychiatrist in the guise of getting a consultation for yourself, say for depression and let the psychiatrist try to counsel him.

I do hope I was able to answer your query. Please let me know if I can be of further help to you.

Best wishes,

Dr. Sunil Gupta


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sunil Gupta (4 hours later)
Dear Sir,

The problem is that he can't admit himself that he is addicted. As per him he drink only to make his mood light. But as i told you earlier he get out of control.

What is the right way ....................
Ok can you suggest me some medicine by which he avoid alcohol for some time. meanwhile we continue telling him that he is addicted. And ask him to visit any doctor.
doctor
Answered by Dr. Sunil Gupta (1 hour later)
Brief Answer:
Naltrexone or acamprosate can be tried.

Detailed Answer:
Dear Mrs. XXXXXXX

Thanks for following up. I can understand the problem of denial that you are facing from your husband's side. It is a common phenomenon in many of our patients.

In your husband's case, we will have to be patient and as you said, continue with our efforts. In the meantime, if you want to start any medication, you can try one of the anti-craving drugs like acamprosate or naltrexone. I would not recommend disulfiram at this stage as it can be fatal, if your husband takes it with alcohol.

Acamprosate and Naltrexone are both prescription agents. So, you will have to meet a doctor in person for getting it prescribed. The dose of acamprosate is 333 mg 2 tablets 3 times a day. The dose of Naltrexone is 50 mg/day. With Naltrexone, care has to be taken that your husband must not take any opioid containing medicines like tramadol or codeine cough syrups as it will cause adverse reaction with it.

I hope that answers your query. Please let me know if you have any further doubts. In case you have no further queries, you can close the discussion and rate the answer.

Best wishes,

Dr. Sunil Gupta
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sunil Gupta (11 minutes later)
Dear sir,


One more thing. ................... please suggest me some blood test for him. so that i could know his current health situation, means test which shows that he is now having good health now..............test which shows that his health is not goting well ,so that he should stop or reduce his intake of alcohol .

I know he is very emotional and weak internally. if his reports shows any bad sign i make me understand to stop it.
doctor
Answered by Dr. Sunil Gupta (16 minutes later)
Brief Answer:
Liver function tests.

Detailed Answer:
Dear Mrs. XXXXXXX

Thanks for following up. I completely agree with your idea of showing his blood reports to him. It will help him get motivated for quitting. However, it will work only if the blood tests return some abnormality.

The blood tests that I will recommend will be complete blood counts (Hb, TLC, DLC, MCV, MCHC, PCV, and peripheral blood smear), Liver function tests (bilirubin, SGOT, SGPT, and GGT), renal function test, and lipid profile. The test I will specifically look for some abnormality will be liver functions tests, specifically GGT. Make sure that you ask for GGT to be done as many labs don't include it in when you only ask for liver function tests.

I hope this plan works and you husband soon brings himself into treatment network. I will really wish that things start getting better. Please let me know if I can be of help at any point of time. It will be a privilege to do that.

Best wishes,

Dr. Sunil Gupta
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. Sunil Gupta

Psychiatrist

Practicing since :2005

Answered : 637 Questions

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Suggest Treatment For Alcohol Dependence

Brief Answer: Please see details below. Detailed Answer: Dear Mrs. XXXXXXX I went through your query in detail and can understand what you must be going through. Being with person who gets violent after drinking and moreover, not ready to accept the problem is really traumatic and you must be going through a lot. Let us first see regarding the medical treatment of alcohol dependence. There are two types of medications. The first group includes anti craving drugs like naltrexone, acamprosate, topiramatem, baclofen. These medications help in reducing the craving for alcohol. These medications however, work better only if the patient himself wants to quit drinking. The other medication is termed aversive drug and includes Disulfiram. It cause adverse reactions if a person drinks alcohol together with the medication and as a result of which he starts avoiding alcohol. However, if given without the knowledge of the patient, it may even cause fatal reaction and hence is never recommended without obtaining the patient's consent. Personally, I would not advise any drug to be given without his knowledge. It is important to make him realize that he has problem drinking and he needs to quit. You can also ask your family members and friends to intervene since you yourself have not been successful doing that. Another way out will be to tag him along to a psychiatrist in the guise of getting a consultation for yourself, say for depression and let the psychiatrist try to counsel him. I do hope I was able to answer your query. Please let me know if I can be of further help to you. Best wishes, Dr. Sunil Gupta