Alcohol dependence treatment
by self-limiting

Alcohol dependence can be treated by disulfiram, naltrexone and acamprosate. First one helps in patients self-limiting while two other reduce relapse risk.

Antabuse as self-limiting medicament

One of ways for alcohol addiction treatment is quite smart. It uses substance called disulfiram (trade names of this medicament are Antabuse or Antabus). This medicament can be ingested as tablet or – in some countries – placed under the skin by surgeon what is believed to be more effective because alcohol abuser cannot decide if he wants to take medicament or not. Basics of its action are rather easy to understand. Medicament interacts with a special enzyme called aldehyde dehydrogenase and completely blocks its function. This function is needed to remove alcohol from organism. When alcohol is not removed – due to medicament presence – a series of deterrent and severe effects arise.

Alcohol metabolism and treatment

Let's come closer to this. Ethanol is conversed in liver by oxidation to other simple molecule – acetaldehyde – another one simple, organic molecule. Acetaldehyde is toxic, slowly removable and its presence in body tissues causes nausea, vomiting, headache, short breath, flushing of the skin, accelerated hear rate. That's why our organism is trying to use some chemical reaction on acetaldehyde – simply to destroy it. And here comes enzyme called aldehyde dehydrogenase, which was created by evolution to converse acetaldehyde to acetic acid. Acetic acid is main, other than water, ingredient of vinegar. It's much less toxic compound – harmless when concentrations are low – and is easily removable from body in natural ways of physiology. Enzyme only catalyzes this conversion what means enzyme makes it much more faster. However, without enzyme production of acetic acid from acetaldehyde is as slow as it would never happen.

Blocking aldehyde dehydrogenase

Hence, when we find molecule that has an ability to block this enzyme, alcohol metabolism stops at acetaldehyde stage. It's very slowly removed from body and unpleasant effects, which are characteristic in weaker(!) form for alcohol intoxication or hangover, appears and last for a long period of time. Now, when someone who uses disulfiram during alcohol addiction and dependency treatment tries alcohol – effects are severe and immediate. Patient is much more sensitive to alcohol and in consequence bewares of alcohol. Medicament acts as a prevention from alcohol abuse and helps in treatment by great decreasing addict's ability to get drunk. I mean that it greatly improves his or her self-limiting. It's effective especially among well-motivated addicts. However, patient have to be well informed by physicians about medicament effects and he have to allow to use it. All product, not only alcoholic beverages – like sweets containing alcohol and shaving lotions have to be avoided. Unfortunatelly this treatment should not be used within patients with heart problems because mixture of disulfiram and alcohol can lead to cardiovascular collapse.

Few end words

Medicament is active for up to two weeks. There's no tolerance so its effects do not decrease with next doses – quite contrary. However, there are some controversy with disulfiram. Among side effects there are: tingling of the lower legs, liver toxicity and failure, numbness. Moreover, disulfiram may interact dangerously with some stimulant drugs (cocaine, amphetamines) leading to paranoia, sleeplessness or stimulant psychosis.