What are the treatments?
Medically, three medications are approved for alcohol use disorder in Canada: naltrexone, acamprosate, and disulfiram. Some other medications can be used as well but are "off label".
Social treatments include 12-step approaches such as Alcoholics Anonymous and Celebrate Recovery, as well as non-AA based community support programs like Women for Sobriety or Secular Sobriety or SMART recovery.
Counselling 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. Local counselling is available at Fourcast and Hastings Prince Edward Addictions and Mental Health.
Medical treatments for Alcohol
Naltrexone is 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.
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 really work. The side effects are mild and short lived and include feeling itchy and stomach upset. You should not use this 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.
Withdrawal Management
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.
How do I know what treatment is right for me?
This will depend on a lot of things - including how each medication makes you feel, how you pay for your medication, and what other health issues you have.
How do I get started?
Please call us to set up an intake visit. Due to CoVid19, we no longer have drop in times, but we are able to offer same day phone appointments, video appointments and in person visits. To minimize the amount of time you spend in the waiting room, we use secure messaging portals that allow you to fill in a lot of information before you even arrive. 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.
This is an excellent video from David Suzuki and the CBC on alcohol use disorder and its treatments and experience. http://www.cbc.ca/natureofthings/episodes//wasted
Dr Holowaty Medicine