At WellStep Atlanta’s alcohol treatment program, Antabuse (disulfiram) is often prescribed along with “anti-craving” medication to help patients resist the temptation to relapse to alcohol use. This medication causes unpleasant effects when even small amounts of alcohol are consumed. These effects include flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety. These effects begin about 10 minutes after alcohol enters the body and last for 1 hour or more. Disulfiram is not a cure for alcoholism and does not directly help alcohol cravings but does discourage drinking. The patient should not take disulfiram for at least 12 hours after drinking. A reaction may occur for up to 2 weeks after disulfiram has been stopped. It is preferable if a spouse, parent, or “significant other” can administer this medication to help ensure the patient takes it regularly. Antabuse is usually started shortly after detox and taken for about six months during which time patients continue counseling and support group activities. For more information on WellStep’s alcohol treatment program, please visit www.WellStep.com.
The WellStep Atlanta alcohol Treatment Program offers outpatient detox services to carefully selected patients who would like to avoid a hospital stay.
Outpatient detoxification is an effective, safe, and low-cost treatment for patients with mild to moderate symptoms of alcohol withdrawal.
Patients with serious psychiatric conditions, concurrent acute illness, severe alcohol withdrawal symptoms, or those who are at high risk for developing delirium tremens, and those with serious health problems are best detoxified in an inpatient setting. Other conditions precluding outpatient detox include coexisting acute or chronic illness requiring inpatient treatment, current severe alcohol withdrawal and pregnancy. A seizure disorder or history of severe alcohol withdrawal seizures is a contraindication, as is the lack of a responsible adult to monitor the patient at home and the inability of the patient to make daily follow-up visits to the office for 3-5 days.
Treatment typically includes daily prescribing of medication to make the patient comfortable and prevent serious withdrawal symptoms. At WellStep, carbamazepine (Tegretol) and benzodiazepines (Valium/Librium) are often used. Other medications may be utilized as well certain vitamins necessary to prevent serious complications, most importantly Thiamine.
For more information, please visit www.WellStep.com or call 770-753-9898
At our Atlanta alcohol treatment program, we often prescribe Campral, which is helpful in maintaining abstinence (no drinking at all) in patients who have stopped drinking by the time the medication is started.
The effectiveness of Campral in preventing relapse has not been demonstrated in individuals who have not undergone detox and have not achieved alcohol abstinence prior to beginning Campral treatment. In another words, Campral will probably not be helpful if a patient continues to drink while taking it. Campral will not reduce withdrawal symptoms in a detox situation.
How Campral works to maintain abstinence is not well understood but it is felt to influence the GABA and Glutamate neurotransmitter system.
The dosage of Campral is two 333mg pills three times a day and Campral may be taken with or without food.
Patients who cannot take Campral are individuals who have a hypersensitivity to acamprosate and patients whose have severe renal impairment. Since Campral is not metabolized in the liver, it is usually safe for patients with mild to moderate hepatic (liver)impairment. Patients must discontinue Campral immediately if any suicidal thoughts arise and families and caregivers of patients should monitor for symptoms of suicidal thinking.
For more information on Campral or our Atlanta alcohol treatment program, please visit www.WellStep.com or call 770-753-9898
At our Atlanta alcohol treatment program, WellStep utilizes Vivitrol (naltrexone) as one of several medications that help reduce alcohol cravings.
Here’s some of the most common questions we have been getting on Vivitrol from our patients:
What is Vivitrol? Vivitrol is an injectable form of naltrexone, an opiate blocker, that has a one month duration of action.
What is Vivitrol used for? According to the official prescribing information, “Vivitrol is indicated for the treatment of alcohol dependence in patients who are able to abstain from alcohol in an outpatient setting prior to initiation of treatment with VIVITROL. Patients should not be actively drinking at the time of initial Vivitrol administration ”In other words, patients is designed for patients who still have cravings after stopping drinking. (Vivitrol has also shown to reduce the number of “heavy drinking days” so may be effective for “binge drinkers” as well.)
How does Vivitrol work? From the official prescribing information: “The neurobiological mechanisms responsible for the reduction in alcohol consumption observed in alcohol-dependent patients treated with naltrexone are not entirely understood.However, involvement of the endogenous opioid system is suggested by preclinical data.” In other words, how Vivitrol works is not entirely understood. But scientists feel it may affect the “reward system” by working as an opiate blocker, so that alcohol does not produce the same pleasurable action as previously.
Where is this shot given? The injection is intramuscular and is given in the gluteal area.
Who cannot take Vivitrol?
Patients with acute hepatitis or liver failure
• Patients receiving opioid analgesics
• Patients with current physiologic opioid dependence
• Patients in acute opioid withdrawal
• Any individual who has failed the naloxone challenge test or has a positive urine screen for opioids
carboxymethylcellulose, or any other components of the diluent
Is Vivitrol expensive? Yes, however most health insurance plans appear to be covering Vivitrol at the moment.
For more information on Vivitrol, visit www.Vivitrol.com . For specific questions on how Vivitrol is used at WellStep, please visit www.WellStep.com
Atlanta alcohol treatment on an outpatient basis is available at WellStep, a private addiction medicine practice located in Roswell, GeorgiaTreatment may include detox for selected patients or a variety of FDA-approved medications to help reduce alcohol cravings. Counseling referrals are made as well to licensed professional counselors who are expert in helping patients struggling with alcoholism. Mark S. Banov, MD, MPH, FACPM is medical director of WellStep’s outpatient alcohol treatment program. Dr. Banov is Board Certified in Addiction Medicine by the American Board of Addiction Medicine. He is a graduate of Johns Hopkins University and the Harvard School of Public Health and received his medical degree from the Medical University of South Carolina. Along with his clinical practice, Dr. Banov serves as a Principal Investigator and Clinical Investigator for FDA-regulated clinical research studies in the areas of addiction and behavioral medicine. For more information on WellStep’s programs, please visit www.WellStep.com