Treatment of alcohol dependence:-
There are several methods to leave the habit of daily alcohol consumption.
Behaviour therapy
Behavior therapy is a type of psychotherapy that focuses on modifying maladaptive behaviors and replacing them with more adaptive ones. It is based on the principles of behaviorism, which emphasizes the role of learning and reinforcement in shaping behavior.
It may also be used to treat certain physical health conditions like cigarette smoking, eating disorders and alcohol abuse.
Aversion therapy is a type of behaviour therapy used in alcohol dependent patient.
Behavior therapy can be delivered in a variety of settings, including individual therapy, group therapy, and self-help programs. It has been shown to be effective for many people, particularly when combined with other treatments such as medication or cognitive-behavioral therapy.
Aversion therapy
- It is the form of behaviour therapy where negative reinforcement is used to change behaviour.
- Aversion therapy is a type of behavior therapy that aims to reduce unwanted behaviors by pairing them with unpleasant stimuli, with the intention of creating an aversion or negative association towards the behavior.
- If a punishment is given after a specific behaviour than a specific behaviour will be inhibited.
- In chemical aversion therapy, a patent may be treated with a drug (disulfiram) that makes the consumption of substance (such as alcohol) extremely unpleasant.
Example – If a patient on disulfiram therapy use alcohol, experience unpleasant response (nausea, vomiting) instead of pleasant response (euphoria) that usually Feel after alcohol consumption. - It is used in alcohol abuse, paraphilia (a psychosexual disorder in which usually imagery or acts are necessary for sexual excitement), homosexuality and transvestism.
Disulfiram (alcohol sensitising drug)
- Disulfiram discovered in 1930 and become drugs of choice in alcohol dependence patient.
- When alcohol is ingested by a person who is on disulfiram therapy the patient feels bad experience.
Mechanism of action of disulfiram. - It inhibits the enzyme aldehyde dehydrogenage.
- Aldehyde dehydrogenage convert acetaldehyde (a metabolite of alcohol) into acetate.
- Thus level of acetaldehyde increase in the body during disulfiram therapy, which is characterised by following symptoms :-
Palpitation
Perspiration
Nausea & vomiting
Flushing of face
Anxious feeling
Giddiness / dizziness / vertigo.
Headache
Hypotension
Dyspnea
Tremors
NOTE :- Patient must abstain from alcohol for at least 12 hours before the initial dose and 14 days after the last dose of disulfiram.