Alcohol Treatment Scottsdale | Phoenix
Dr. Jack Shier, Psychiatrist in Scottsdale, AZ specializes in the treatment of alcohol use disorder/alcohol dependence. Our private outpatient clinic offers a comprehensive psychiatric/medical assessment and treatment plan. Treatment may include medications, behavioral therapies or a combination of treatments.
What Is Alcohol?
Alcohol (ethyl alcohol or ethanol), is the recreational ingredient found in beer, wine, and liquor. When used at low doses, individuals may experience a stimulant-like effect, eliciting feelings of euphoria and talkativeness. At higher doses, it has a sedative-hypnotic effect inducing drowsiness and respiratory depression.
What Are the Side Effects of Alcohol?
The immediate side effects of alcohol may include, but are not limited to, balance problems, loss of hearing, memory loss, slowed reaction times, anxiety, restlessness/insomnia, blurred vision, lowered inhibitions, lowered body temperature and slurring of speech. Symptoms of excessive alcohol intake may extend to more serious side effects such as nausea, vomiting, incontinence, blackouts, temporary unconsciousness, coma or death.
What Are the Long-Term Effects of Alcohol Use?
Long-term alcohol use affects how the brain functions in terms of mood, behavior and coordination by interfering with the brain’s communication pathways. Individuals may suffer from a myriad of additional physical ailments including weakened immune systems, making it harder for the body to fight off disease. Excessive alcohol use over a long span of time may cause damage to the heart causing high blood pressure, cardiomyopathy, arrhythmias and/or stroke. Additional organ systems affected include liver and pancreas, leading to fatty liver, alcoholic hepatitis, cirrhosis, fibrosis or pancreatitis. Heavy alcohol use may also erode the protective lining of the esophagus and stomach, leading to ulcers and internal bleeding. An individual’s risk for developing cancers of the mouth, esophagus, throat, liver and breast may also be heightened by the use of alcohol.
What Causes Alcohol Addiction?
Neuroscience research has identified a relationship between the addictive properties of alcohol and the reward center of the brain. In both heavy and light drinkers, alcohol causes the release of endorphins (naturally-occurring, feel-good opioids) in the two brain regions associated with processing rewards, the nucleus accumbens and orbitofrontal cortex. Individuals whose brains release greater amounts of endorphins in response to alcohol may get more pleasure from drinking alcohol and may be more likely to develop an alcohol use disorder.
A single causal factor for alcohol addiction has not been identified. Both genetic and environmental factors contribute to the development of an alcohol use disorder. Increased risks may be associated with how an individual’s brain processes alcohol (through the release of endorphins) or one’s sensitivity to stress, making it harder to cope with obstacles, leading to self-medication.
What Is an Alcohol Use Disorder?
According to the DSM-5, the diagnostic criteria of alcohol use disorder (AUD) include:
A problematic problem of alcohol use leading to clinically significant impairment or distress as manifested by at least two of the following within a 12-month period:
- Alcohol is often taken in larger amounts or over a larger period than was intended.
- There is a persistent desire or unsuccessful attempts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain or use alcohol or recover from its effects.
- Craving or strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerance as defined by either of the following
- A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
- A markedly diminished effect with continued use of the same amount of alcohol.
- Withdrawal as defined by either of the following
- Cessation or reduction of alcohol use that has been heavy and prolonged and/or the development of two or more of the symptoms of alcohol withdrawal in the following several hours to a few days after the cessation of alcohol use.
- Alcohol (or closely related substance, such as benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
What Are the Symptoms of Alcohol Withdrawal?
According to the DSM-5, alcohol withdrawal, which is most likely to occur several hours to a few days after the cessation of alcohol use may include, but is not limited to symptoms of: autonomic hyperactivity, increased hand tremor, insomnia, nausea or vomiting, transient visual, tactile or auditory hallucinations or illusions, psychomotor agitation, anxiety, generalized tonic-clonic seizures and delirium tremens. Delirium tremens, the most severe form of alcohol withdrawal presents with altered mental status and confusion as well as autonomic hyperactivity, and has the potential to progress to cardiovascular collapse. Delirium tremens is considered a medical emergency, with a 5%-25% mortality rate.
What Is the Treatment for Alcohol Addiction?
Treatment for alcohol use disorder may include medications, psychotherapy, and 12-step meetings. It has been shown that a combination of these three methods results in greater remission of symptoms.
The FDA currently has three approved medicines for the treatment of alcohol use disorder: Naltrexone, Acamprosate, and Disulfiram. Naltrexone, also known by the brand names of Revia and Vivitrol, helps reduce heavy drinking by diminishing the pleasurable effects of alcohol and reducing cravings by blocking mu opioid receptors in the brain. By blocking the mu opioid receptors, Naltrexone may diminish the euphoric effects of alcohol. Acamprosate, also known by its brand name Campral, helps influence abstinence from alcohol use by reducing excitatory glutamate neurotransmission and increasing inhibitory GABA neurotransmission. Withdrawal following chronic alcohol use generally leads to excessive glutamate activity and insufficient GABA activity. Acamprosate acts as an “artificial alcohol” by binding to and blocking certain glutamate receptors to mitigate withdrawal effects. Disulfiram (Antabuse) works by blocking the metabolism of alcohol in the body, causing uncomfortable symptoms such as nausea, headache, vomiting and flushed skin. These symptoms may help individuals avoid alcohol use when taking Disulfiram in order to avoid the unpleasant side effects.
A combination of Motivational Interviewing (MI) and Cognitive behavioral therapy (CBT) have also shown to be helpful in the treatment of alcohol use disorder. MI focuses on activating internal motivating factors with support through the stages of change. CBT focuses on identifying feelings, modifying distorted thoughts, and finding alternatives to maladaptive behaviors.
How to Cope?
- Maintaining a balanced lifestyle can help an individual manage alcohol addiction.
- Relaxation techniques – Participating in mindfulness meditation or deep breathing exercises can reduce an individual’s overall stress level and may help curb maladaptive urges to use alcohol.
- Exercise routine – 30 minutes of daily aerobic exercise may help manage alcohol addiction by reducing anxiety and diverting an individual’s attention away from alcohol use.
- Good sleep hygiene – Healthy sleep patterns promote a stronger ability to maintain emotional equilibrium, making it easier to maintain stress and avoid the use of alcohol.
- Avoid activities surround ETOH use – Engage in activities that are not associated with alcohol use in order to prevent urges. Increase number of social contacts that are not associated with alcohol use/that do not promote the use of alcohol.
- Find new interests – Partaking in hobbies, interests or work that you find fulfilling will make you feel better about yourself and your time and may reduce the appeal of drinking alcohol.
- Join 12-step/support group – Support groups will help you meet others with similar experiences, share coping strategies, and gain a sense empowerment and connection.
Last update: July 12, 2017
The content on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.