top of page
  • Writer's pictureDr. Harold Pierre

Alcohol Addiction and Some Exciting New Treatment Options

Updated: Dec 7, 2023

Alcohol Addiction and Some Exciting New Treatment Options


For many folks, alcohol's a beloved part of celebrating and relaxing after work. But alcohol can also become an addictive and dangerous substance when abused. I'm an addiction doc who's seen firsthand the ruinous impacts of alcohol addiction. In this post, I'll explain the disturbing science behind addiction, how to spot the red flags, and most vital - the treatment options offering hope for recovery. My aim's to empower you with truth and practical solutions, friend. Achieving freedom ain't easy, but it's possible with grit and support.


What Exactly is Alcohol Addiction?


Problem of alcoholism among adolescents

Alcohol addiction, also known as alcoholism or alcohol use disorder, is a chronic disease characterized by uncontrolled drinking and preoccupation with alcohol despite negative consequences. People suffering from alcohol addiction prioritize alcohol use over other activities and obligations. They continue to abuse alcohol despite legal, health, financial or relationship problems.


According to the latest Diagnostic and Statistical Manual of Mental Disorders (DSM–5), alcohol addiction is diagnosed when someone meets two or more of the following criteria within a 12-month period:

  • Drinking more alcohol or for longer than intended.

  • Persistent desire or unsuccessful efforts to cut down on alcohol use.

  • Great deal of time spent obtaining, using, or recovering from alcohol.

  • Cravings and urges to use alcohol.

  • Failure to fulfill major role obligations due to repeated alcohol use.

  • Continued alcohol use despite social or interpersonal problems caused or worsened by drinking.

  • Giving up important social, occupational or recreational activities due to alcohol use.

  • Recurrent use of alcohol in hazardous situations.

  • Alcohol use continues despite knowledge of alcohol-related physical or psychological problems.

  • Tolerance - need for increased amounts of alcohol to achieve desired effect.

  • Withdrawal symptoms when alcohol use is abruptly reduced or stopped.

Based on the number of criteria met, alcohol addiction can range from mild to moderate to severe. But all forms significantly disrupt normal functioning and quality of life.


Why Do People Get Addicted to Alcohol?


The causes of alcohol addiction are complex and not fully understood. Research suggests genetics, environment, brain chemistry and social factors all play a role.

  • Genetic predisposition - Certain gene variations affecting brain pathways for reward, pleasure, impulse control and alcohol metabolism may increase addiction vulnerability.

  • Early exposure - Starting drinking during the teen years when the brain is still developing seems to increase addiction risk later in life.

  • Brain chemistry - Alcohol triggers the release of dopamine and endorphins, brain chemicals that promote feelings of pleasure and reward. Chronic alcohol use can dysregulate these pathways, leading to cravings and compulsive behavior.

  • Self-medication - Those struggling with anxiety, depression or trauma may use alcohol to "self-medicate" difficult emotions and memories. Over time, this coping mechanism can evolve into addiction.

  • Environmental factors - Peer pressure, culture, stress or economic status may encourage heavier drinking and make alcohol addiction more likely for some.

In essence, alcohol addiction develops when the rewarding effects of alcohol hijack the brain's normal pleasure/reward pathways. Over time, these pathways get conditioned to crave alcohol, while executive control functions weaken - making it very difficult to voluntarily reduce drinking no matter the consequences.


Recognizing the Signs and Symptoms of Alcohol Addiction


Wondering if you or someone you care about may be struggling with alcohol addiction? Here are some common signs and symptoms to watch for:

  • Drinking alone or in secret.

  • Gulping drinks, drinking faster than others.

  • Feeling irritable, restless or anxious when sober.

  • Failed attempts to quit or control drinking.

  • Making alcohol a priority over work, school, family or health.

  • Risky behavior while intoxicated like drunk driving.

  • Spending significant time drinking, obtaining alcohol or recovering from hangovers.

  • Neglecting hobbies, social activities and appearance due to alcohol use.

  • Relationship conflicts, legal trouble or work problems related to drinking.

  • Excuses and justifications for excessive alcohol use.

  • Needing more alcohol to get same effect (increased tolerance).

  • Withdrawal symptoms like nausea, sweating and shaking when not drinking.

Pay attention if you or a loved one regularly exhibits several of these signs. The more that are present, the more urgent the need for change.


The Harmful Effects of Alcohol Addiction


Panoramic shot of suffering man sitting on floor by white wall near bottle and glass of whiskey copy

Alcohol addiction destroys lives - impacting health, relationships, finances and more. Consider the wide-ranging effects of prolonged alcohol use:

  • Brain damage - Shrinking of brain tissue, Wernicke-Korsakoff Syndrome.

  • Liver disease - Fatty liver, alcoholic hepatitis, fibrosis, cirrhosis.

  • Digestive problems - Gastritis, ulcers, pancreatitis.

  • Heart disease - Cardiomyopathy, arrhythmias, stroke.

  • Cancer - Mouth, esophagus, liver, breast.

  • Weakened immune system.

  • Bone loss, muscle myopathy.

  • Sexual/reproductive dysfunction.

  • Sleep disorders.

  • Depression and suicidal thoughts.

  • Family turmoil, domestic violence.

  • Lost productivity and unemployment.

  • Financial devastation.

  • Legal problems - DUIs, public drunkenness.

In addition, binge drinking and alcohol poisoning pose serious acute risks like alcohol overdose, accidents and risky behavior leading to trauma or death.

Clearly, alcohol addiction wrecks health and destroys lives. So when does regular drinking cross the line into addiction?


Has My Alcohol Abuse Become a Problem?


Not everyone who drinks regularly has an addiction. But how do you know when your relationship with alcohol has become unhealthy? Ask yourself these questions:

  • Do I sometimes drink more than intended or lose control of my drinking?

  • Do I want to cut down or quit drinking but haven't been able to?

  • Have friends or loved ones expressed concern over my drinking?

  • Do I sometimes drink heavily or alone to cope with stress or difficult emotions?

  • Does my drinking cause problems in my relationships or daily functioning?

  • Have I missed work or neglected responsibilities because of drinking?

  • Have I risked physical safety through intoxication?

  • Have I kept drinking despite signs it's harming my health?

  • Do I need more alcohol to get the desired effect compared to when I first started drinking?

Answering yes to even a few of these questions indicates your alcohol use could be problematic. The more you answered yes, the more urgent the need for change.


Treatment Options for Alcohol Use Disorder


Battling alcohol addiction on sheer willpower alone rarely works. The altered brain pathways and withdrawal symptoms make sobriety extremely difficult. Recovery from alcohol use may require a professional treatment provider. There are proven treatment options that can help:


Inpatient Alcohol Rehab


Inpatient or residential rehab provides intensive round-the-clock treatment while living full-time at a treatment facility. In addition to medical detox, patients receive behavioral counseling, skills training and peer support. The average stay is 30 days, but can vary based on needs.


Benefits: Removes patients from triggers and stressors that contributed to addiction. Focused immersion in treatment fosters lifestyle changes. Higher rates of long-term recovery compared to outpatient programs.


Outpatient Alcohol Rehab


Outpatient programs offer addiction treatment several hours per day while allowing patients to live at home. Programs are either intensive (9+ hours/week) or traditional (1-2 hours/week). Treatment includes counseling, education, skills training and peer support groups.


Benefits: Patients maintain work, family commitments and local support systems. Lower costs compared to residential rehab. Flexibility to adjust intensity based on changing needs.


Medication-Assisted Treatment for Alcohol Use Disorder


Multiethnic people calming sad man with alcohol addiction during group therapy in rehab center, banner copy

Certain medications can help manage alcohol addiction by easing withdrawal symptoms, reducing cravings, and blocking the rewarding effects of drinking. Let's explore how these medicines work and key facts to know:


Naltrexone

  • FDA-approved to treat alcohol abuse and alcoholism since 1994. Also used for opioid addiction.

  • In my experience, this is THE BEST medication to treat alcohol addiction.

  • Works by blocking opioid receptors and the euphoric effects of endorphins released when drinking alcohol.

  • Reduces alcohol cravings and the rewarding feeling from drinking alcohol.

  • Given as a daily pill or extended-release monthly injection (Vivitrol).

  • Should not be given to those actively dependent on opioids, as it will trigger severe withdrawal.

  • Common side effects include nausea, headache, dizziness, anxiety and trouble sleeping.

Acamprosate

  • FDA-approved to treat alcohol addiction since 2004. Thought to calm overactive glutamate pathways.

  • Helps reduce anxiety, insomnia, restlessness and other distress when first quitting alcohol.

  • May help deter drinking by easing protracted withdrawal symptoms.

  • Does not treat cravings directly but improves mood stability in early recovery.

  • Taken as pill 3 times per day. Common side effects include headache, dizziness, nausea, diarrhea.

Disulfiram

  • Approved to treat alcohol addiction since the 1950s. Long history of use.

  • Works by blocking acetaldehyde breakdown, causing unpleasant reaction when drinking alcohol.

  • Discourages drinking through unpleasant flushing, nausea and headache if alcohol is consumed.

  • Rarely used alone due to high noncompliance. Sometimes used with monitoring or implants.

  • Can cause hepatotoxicity in high doses. Use cautiously if history of cardiovascular disease.

Gabapentin

  • Approved for seizure and nerve pain treatment. Used off-label to manage alcohol addiction.

  • Thought to work by modulating glutamate neurotransmission and restoring GABA inhibition disrupted by alcohol misuse.

  • Shows some efficacy in reducing drinking frequency, heavy drinking days and cravings.

  • Usually given as daily pill but optimal dosing unclear. Well-tolerated but potential for misuse.

Baclofen

  • A muscle relaxant sometimes prescribed off-label to treat alcohol addiction.

  • Activates GABA-B receptors, which may reduce dopamine release and reward from drinking alcohol.

  • Limited evidence it increases abstinence rates or reduces drinking. But shown to reduce cravings and anxiety.

  • Given as a pill 3 times per day. Side effects include dizziness, fatigue, nausea and muscle weakness.

Benzodiazepines

  • Anti-anxiety medications like diazepam (Valium) used to treat acute alcohol withdrawal symptoms.

  • Work by increasing GABA inhibition to counteract glutamate excitation from alcohol withdrawal.

  • Help control withdrawal symptoms like tremors, agitation, seizures and delirium tremens (DTs).

  • Given short-term and tapered due to habit-forming potential. Increase overdose risk when mixed with alcohol.

  • Helps treat life-threatening withdrawal symptoms

Anticonvulsants

  • Anti-seizure medicines like topiramate and gabapentin may help reduce drinking and cravings.

  • Exact mechanisms unclear but may involve GABA and glutamate regulation disrupted by alcohol abuse.

  • Mixed evidence on efficacy but shown to reduce heavy drinking days and promote abstinence for some.

  • Generally well-tolerated but can cause side effects like dizziness, fatigue or cognitive impairment.

Experimental Agents

Emerging treatments for alcohol addiction and relapse prevention include:

  • Psilocybin - active ingredient in psychedelic mushrooms shows promise for disrupting addictive behaviors through effects on serotonin and dopaminergic signaling. Small studies show it may prevent relapse and promote abstinence when combined with therapy.

  • Ketamine - anesthetic and depressant shows potential to quickly reduce cravings and alcohol consumption in early studies. May work by regenerating neural connections damaged by alcohol addiction. Currently being studied in clinical trials.

  • Ibudilast - anti-inflammatory and vasodilator medication reduced alcohol self-administration and heavy drinking days in preliminary studies. Thought to modulate glial cell function and neuroinflammation linked to alcohol addiction.

  • Ozempic (semaglutide) and Mounjaro (Tirzepatide) - these diabetes drugs can significantly reduce alcohol intake and in some people eliminate their cravings for alcohol. I've developed a protocol to use these along with naltrexone for alcohol addiction treatment. It has been a game-changer.

Why Naltrexone Works Well for Some But Not Others


There are a few key reasons why the medication naltrexone may work well for some individuals with alcohol addiction but not others:

  • Genetics - Research suggests a variant of the OPRM1 (opioid receptor mu 1) gene called Asn40Asp may cause some people to respond better to naltrexone. Those with the Asp40 version experience greater alcohol reward that is blunted by naltrexone.

  • Metabolism - Differences in how people metabolize and excrete naltrexone likely impact the drug's efficacy. Faster metabolism could reduce therapeutic levels of the drug.

  • Compliance - Naltrexone only works if taken regularly as prescribed. Lack of compliance or skipping doses reduces its effectiveness for alcohol addiction.

  • Severity - More severe cases of long-term alcohol addiction may be harder to treat with naltrexone alone. The drug may work better for milder cases or as adjunct to therapy.

  • Comorbidities - The presence of concurrent mental health disorders like depression or anxiety may reduce naltrexone's effectiveness in some individuals.

  • Brain chemistry - Pre-existing differences in endorphin and opioid receptor function in the brain could cause varied responses to naltrexone among different people.

  • Placebo effect - Some people may perceive benefits from naltrexone solely due to expecting improvement rather than the drug's actual effects.

Peer Support Groups

Groups like Alcoholics Anonymous (AA) offer free peer support for achieving and maintaining sobriety. Members share personal stories and meet regularly to promote accountability. A sponsor provides one-on-one guidance.


Benefits: Widely available including virtual meetings. Ongoing non-clinical support and fellowship. Lifetime membership focused on relapse prevention.


Tailored Treatment Improves Long-Term Recovery


There's no one-size-fits-all solution for alcohol addiction. The best recovery plans start with a professional evaluation assessing:

  • Drinking history patterns and triggers.

  • Physical and mental health.

  • Family history and genetic risks.

  • Treatment goals – abstinence vs moderation.

  • Challenges – finances, transportation, legal issues.

This allows addiction specialists to recommend tailored treatment addressing each patient's specific needs for the best chance at lasting success. Ongoing follow-up care and support is also key to prevent relapse.


Don't Let Shame Deter You From Seeking Help


The stigma surrounding alcohol addiction causes many to suffer silently rather than seeking help. But addiction is a medical disease, NOT a personal failing. It can happen to anyone - even the most successful among us.


Getting support is a courageous act that requires enormous strength. If you're concerned about a loved one's drinking, have an honest, caring conversation free of blame and judgment. Voice your support in getting help. Backup is available through organizations like Al-Anon designed for families and friends struggling with a loved one's alcohol addiction.

No matter how desperate the situation may seem, there is reason for hope. The brain is remarkably capable of healing if given the proper professional treatment and time. Freedom from alcohol addiction IS possible. By taking the first step and reaching out for help, you can reclaim your health, your purpose and most importantly your life.


I am Here to Help


I lead a team with decades of experience, a commitment to providing you with comfort, care, and respect as you navigate this challenging time in your life. We also make treatment super convenient with hours of operation that extend from 0800 AM to 0900 PM, 7 days a week through scheduled appointments, accept most insurances, making addiction treatment accessible to practically all who call 918-518-1636. We are conveniently located in Tulsa, Oklahoma and The Woodlands, TX. We are waiting for your call.


Key Takeaways on Alcohol Addiction and Treatment

  • Alcohol addiction is a chronic disease involving compulsive drinking and loss of control over alcohol use.

  • Genetics, upbringing, brain chemistry and environment may influence someone's risk.

  • Look for signs like tolerance, withdrawal, cravings and an inability to quit or cut back.

  • Alcohol addiction can severely damage physical and mental health if left untreated.

  • Seeking professional treatment through rehab, medication, counseling and recovery groups can help overcome alcohol addiction long-term.

  • Tailored programs treat root causes of addiction for better success over one-size-fits all approaches.

  • Supporting a loved one in getting help for alcohol addiction restores hope and saves lives.

This article provides general health information that should not replace medical advice or treatment recommendations from a qualified healthcare professional.


Frequently Asked Questions


What causes alcohol addiction?

Alcohol addiction results from a combination of genetic, environmental, social and neurochemical factors that alter brain pathways governing reward, pleasure and executive control. Prolonged alcohol misuse can hijack these pathways leading to dependence and addiction.


How do you know if you are addicted to alcohol?

Signs of alcohol addiction include inability to control drinking habits, drinking that interferes with regular life and responsibilities, excessive time spent drinking or recovering from alcohol use, persistent cravings and continuing to drink despite alcohol-related problems.


What does alcohol do to your brain?

Alcohol triggers the release of dopamine and endorphins that induce pleasure and reward. But chronic heavy alcohol use can overstimulate these pathways and desensitize the brain's reward system. This leads to increased tolerance and alcohol cravings. It also impairs executive functions like judgment, decision-making and self-control.


Can alcohol change your personality?

Prolonged heavy drinking can certainly change someone's personality by impacting brain regions controlling emotions, motivation and impulse control. People addicted to alcohol may become more irritable, apathetic, reckless, isolated and secretive over time under the influence of alcohol.


How quickly can you get addicted to alcohol?

There is no definite timeline for becoming addicted to alcohol. Factors like genetics, age of first use, quantity/frequency of drinking and environmental stressors all play a role. Some people may become addicted within months of initial use. While chronic alcohol use can lead to addiction in others. Binge drinking and starting during adolescence increase addiction risk.


How do you stop drinking alcohol on your own?

Attempting to stop drinking without assistance rarely succeeds long-term due to withdrawal symptoms and cravings caused by alcohol addiction's effects on the brain. Getting medical help through detox, counseling therapy, peer support groups and/or medication improves the chances of recovering without relapsing.


How is withdrawal treated?

Treatment professionals have multiple drug options to treat withdrawal. Gabapentin, Valium can treat moderate to severe withdrawal symptoms.


About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.


This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.




31 views0 comments

Comments


bottom of page