Tag Archives: alcoholism

Gabapentin for Alcohol dependence

October 23, 2014

 

Gabapentin: New Hope for Alcohol Dependence

GabapentinIn the past treating alcohol and drug addicts has never been easy. Alcohol and other drugs dependence is a vice that has not only affected adversely the lives of the addicts and their dependants but also the community as well. In most cases we think that drug and alcohol dependence only affects the addicts, hell no we are wrong. The cost of these drugs and alcohol might be cheap since alcohol is readily available and can be bought at different quantities and prices. The reality is that the cost of alcohol dependence is too high to the society than it really is to the addicts themselves. Alcoholism has rendered many people jobless since their employers could not put up with their addiction. In this case the addict will not have means to get his daily quantities of alcohol to get high but the craving will be at its peak, the addict will therefore have to find other ways of getting money to buy alcohol even if it means breaking some laws. Being dependent on alcohol has made many people criminals and that is a cost that the society has to pay but unfortunately it is a cost hidden to many people.

The cost of alcohol dependence does not end there. Think of the government sponsored researches that have to be done to find ways of helping the addicts to overcome their nightmare. The cost of putting up rehab centers to cater for alcohol addicts who have become pests to their families, the very people they have a responsibility to provide for. In the past many researches have been done to find out the best medicine that could be of help to those dependent on alcohol. Alcohol dependence has affected the economy of most continents but according to a recent research finding there is a ray of hope to treatment of alcohol dependence.

A recent study that was done at San Diego by Researchers at The Scripps Research Institute declared new hope in the treatment of alcoholism in November 2013, following the results of a new study to treat the disease with a drug that is already on the market. The presence of the drug in the market is already a breakthrough as no more will be spent to establish the medicinal ability of this drug to treat alcoholics and set them free from the chains of alcohol dependence. Unlike in most cases where after a research finding the search for drugs sets in , this finding has an already available drug and that is an advantage to the would be users.

According to the research finding; Gabapentin which is already being used as a prescription drug for people suffering from epilepsy as well as for patients with some pain, including migraines is equally good for fighting alcohol dependence. This new study found the drug appears to be safe and effective in the treatment of alcohol dependence. This research finding has brought some new hope in the field of alcohol addiction treatment and recovery.

More effective in treating alcohol dependence

“Gabapentin’s effect on drinking outcomes is at least as large or greater than those of existing FDA-approved treatments,” said Barbara J. Mason in a news release from the Scripps Research Institute. Mason is the co-director of the Pearson Center for Alcoholism and Addiction Research, who led the new research. If what Mason said is to be believed then people will begin using Gabapentin in place of the drugs that have been approved by FDA already.

“Plus, it’s the only medication shown to improve sleep and mood in people who are quitting or reducing their drinking, and it’s already widely used in primary care—that’s an appealing combination,” Mason said in the release.

It is a known fact that there has never been a cure for alcoholism, but the doctors have always availed drugs to treat the symptoms that are associated with alcohol withdrawal. Some of the prescription drugs that have been used in treating symptoms related to alcoholism include naltrexone, which the National Institutes of Health describes as a prescription to prevent relapse. Alcoholism can also be treated with 12-step programs and psychotherapy. For the 12-step programs and psychotherapy you will need to find a rehab that will best individualize your treatment to help you out.

According to the TRSI researchers , this drug has more benefits as it helps with cravings, depression and sleeplessness often experienced by alcoholics, other drugs that are already approved by FDA for alcoholism are not as effective as gabapentin.

In three months of treatment, TRSI researchers also said the high-dose group refrained from heavy drinking twice as often as the placebo group, and entirely abstained four times as often as the placebo group. They reported the drug also reduced the number of drinks consumed, and said none of the patients reported serious side effects.

“I think that we can now have confidence in the pharmacological effect of this drug,” Mason said in the news release.

gabapentinAlcoholism affects millions of people. In America alone, More than eight million are thought to suffer from alcoholism. The NIH estimates more than 700,000 of them seek treatment every day and with this discovery they might as well be helped.

The new study was described as a “150-patient randomized, placebo-controlled, double blind clinical trial” in the news release. With many researchers still trying the best drug to treat alcohol dependence we should be ready for some new stuff but as for now gabapentin may just be the best for you.

We at AWAREmed Health and Wellness Resource Center are committed to helping all addicts overcome the vice by availing critical information and treatment. Dr. Dalal Akoury (MD) of AWAREmed Health and Wellness Resource Center in Myrtle Beach, South Carolina is experienced in integrative medicine for addiction. Visit her at Myrtle Beach, South Carolina for help.

Gabapentin: New Hope for Alcohol Dependence

 

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Emergency Care

October 12, 2014

 

Doctor’s Responsibility in Emergency Care

The life of a patient should be respected and there are situations in which a patient must be attended to even if he is not able to pay. Doctors know this and so they strive to give help when these situations pop up. There are different kinds of sicknesses. Even in the context of drug addiction there are people who are seeking help to quit addiction while there are people who are at the verge of losing their lives due to drug overdose. In medical laws any patient who needs an emergency response has a right to be treated and even a drug addict who is at the verge of losing his life as a result of addiction is termed an emergency case and so should be treated just like any other person who might have had a road accident and is bleeding uncontrollably. Any person has a right to treatment at the times of emergency since without treatment the person may become disabled or may die.

 

 

 

Situations like cardiac arrest, heavy bleeding, profound shock, severe head injuries, and acutepsychotic states are some examples of emergencies.  Both public and private hospitals have a duty to administer medical care to a person experiencing an emergency. It is therefore in every doctor’s domain to treat a patient that needs emergency response failure to which he shall be legally responsible for the death of the patient.

If a hospital hasemergency facilities, it is legally required to provide appropriate treatment to a person experiencing an emergency. If the hospital is unableto provide emergency services, it must provide a referral for approriate treatment. Hospitals cannot refuse to treat prospective patients onthe basis of race, religion, or national origin, or refuse to treat someone with HIV or AIDS.

Emergency Medical Treatment and Active Labor Act 

In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA) (42 U.S.C.A. § 1395dd), which establishedcriteria for emergency services and criteria for safe transfer of patients between hospitals. This statute was designed to prevent transferring an undesirable patient to another facility.The law applies to all hospitals receiving federal funds, such asMedicare. The law requires hospitals to provide a screening exam to determine if an emergency condition exists, providestabilizing treatment to any emergency patient or to any woman in active labor before transfer, and continue treatment until a patient can bedischarged or transferred without harm. It also delineates strict guidelines for the transfer of a patient who cannot be stabilized. A hospitalthat negligently or knowingly and willfully violates any of these provisions can be terminated or suspended from Medicare. The physician, the hospital, or both can also be penalized up to $50,000 for each knowing violation of thelaw.

When a patient needs emergency attention he should receive it since if it is delayed there might be a loss of life. Therefore if a doctor is asked to attend to a medical emergency as defined in this statement, he must respond. This is both an ethical and legal obligation and therefore every doctor should abide. However rare there will be times when attending a medical emergency is impossible or unsafe for the doctor or patient. If a doctor chooses not to attend he or she may be required to defend that decision in the event of a charge of professional misconduct or criminal prosecution. The patient who needs medical attention is therefore catered for and should not be ignored.

A doctor is at risk of being professionally or criminally responsible of the death of a patient if he or she fails to render prompt and appropriate medical care to any person whether the patient is a current patient has just came in, in a medical emergency. A doctor who chooses not to attend must have good reason and be able to defend this position at a later time otherwise he will be charged in a court of law for medical negligence.

However there are situations when a doctor, may or should not attend a medical emergency. These scenarios may include;

  • if he or she is already attending another emergency
  • if it is more appropriate for an emergency service to attend (i.e. ambulance or rescue helicopter);
  • the geographical location of the doctor is such that another doctor or medical service can attend more promptly;
  • if he or she is off duty at the time of the call and has been drinking alcohol or taken medication or other substances to a level that may adversely influence the doctor’s level of competence;
  • If attending the emergency places the personal safety of the doctor at risk.
  • The doctor may also not attend to the patient if he is not in the right state of health himself or when he knows he is not competent enough to help the patient.

EmergencyHowever a doctor should be able to take good care of the patient even if he is not able to offer any reasonable help to the patient. He should be able to assist the patient to access another health center where he can be helped. If a doctor fails to attend to emergency because of matters of inconvenience he will be charged and prosecuted.

Medical access is a necessity to everyone that is why we at AWAREmed Health and Wellness Resource Center are committed to availing help to patients by availing the needed information and offering them a place to call home. Just call on Dr. Dalal Akoury (MD) today and begin your journey to victory against addiction, cancer and other diseases.

 

Doctor’s Responsibility in Emergency Care

 

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Suicide and Drug Addiction

October 10, 2014

Suicide Rate in Drug Addiction and How to Naturally Prevent

Drug addiction has been known for its destructive effects on the addicts. Most of the side effects are known by many especially depression and other withdrawal symptoms that an addict faces whenever he tries to stop using the drugs. However there is also another serious problem that has now been linked to drug and substance addiction- suicide. Suicide among drug addicts has become a serious problem that have to be curbed as many addicts are finding it the easiest way to end their suffering and depression as they struggle to set themselves free from addiction. Most of the people who commit suicide do it under the influence drugs. The use of opiates like oxycodone and heroin are leading cause of suicides.

Cocaine Use Increased Odd of Suicide Attempt 

Suicide Student Overwhelmed Asking For Helphas been a problem that the society has been fighting with. It has very many causes, however as revealed by a study that was led by Richard Ries MD of Harborview Medical Center University of Washington Seattle, Wa, the major cause of suicide attempts are the use of drugs and substance. This study reveals that of all the major causes of suicide attempts, cocaine use leads by increasing suicide attempts 62 times more likely. This is followed by major depression which increases the odd of suicide attempts 41 times more likely. Alcohol use follows by increasing odd of suicide attempts 8 times more likely. This supports the notion that drug and substance addiction increases chances of a person committing suicide.

In this same study it was found that among other factors divorce and separation increased odd of suicide attempts 11 times more likely. A person may argue that now that divorce and separation also increases the likelihood of a person committing suicide then there is no way to link drug addiction to increased suicide cases. However if deviate from your view you will realize that drug and substance addiction has a bigger role in even divorce and separation. Most of the cases where married parties have to separate or divorce are often linked to drug abuse. A person gets drunk and becomes abusive needless to mention he may not be able to stand with his responsibilities causing the family to break. Socially, the use of drugs and getting addicted to them will even determine the people you relate with and what jobs you will even do. So drug and substance addiction will affect a marriage in many and may be the driving factor that leads to separation linked to increased suicide cases.

However it not reasonable to ignore other factors that may lead to divorce and separation such as infidelity, having abusive partners (some people get abusive even without using drugs), financial problems and other mere misunderstandings. In these cases it calls for counseling in order to rectify the problems before it results in divorce. As it turns saving a divorce may count in reducing the rate of suicide. Marriage counselors may help in restoring peace in a marriage.

What Predicts Suicide Attempts in Alcoholics?

Teen alcohol addiction (drunk teens with vodka bottle)Several studies have linked drug use to increase in suicide attempts. The addicts need to be helped through various ways to help them stay away from suicide thoughts. The doctors have found various ways through which they can predict whether a person addicted to alcohol may attempt suicide or not. These insights may help the doctors to find ways to counsel the addicts to be free from suicide thoughts. One of these pointers is the family history of attempted suicides. When a person has a family member who had committed suicide they are said to develop suicide thoughts. When these suicide thoughts become dominant in their minds they begin to view it as the best solution to end their addiction problems. By studying their family suicide attempt history they can be helped to adopt better ways of solving problems. Another pointer is adverse childhood experience. There are childhood experiences that keep haunting an individual. These thoughts may even be the cause why a person becomes alcoholic. Experiences such as rape, neglect or sodomy may leave a person feeling unworthy and such attitude may cause suicide. The doctors may find ways of helping such an addict to avoid suicide.

Today, suicide has become a major catastrophe. In America alone it is reported that suicide is among top 3 or 4 causes of death in the US from teens to 50. To reduce this rate, there are a lot that needs to be done. Fortunately several studies have shown the major causes of suicide and so an action plan can be developed to minimize the causes of suicidal deaths in both teens and adults not only in America but also in other continents.

Suicide Screen, Assessment Risk and Referral

Suicide is one of the major causes of deaths in teens. For this reasons there is need to screen the alcoholics and even teens for suicide risks. Unfortunately screening for suicide risks has not been utilized in the past majorly because many institutions lack these mental health resources. Risk assessment will be done after the screening to show probability of suicidal death occurring and after this probability is known then various measures can be taken to help the person before he becomes a victim of suicide. In most institutions there may not be abled professionals to handle a subject given the suicide risk factor may be high. In this case referrals become necessary where the person may be taken to more equipped centers with abled professionals who can help prevent such deaths.

Drugs and substance abuse contribute greatly to suicidal deaths and that is why here at AWAREmed we approach addiction integratively so that we not only deal with withdrawal symptoms but also assess other risk factors. Dr. Dalal Akoury (MD) has helped many addicts to retrace their steps and overcome addiction. You can call on her for more help.

Suicide Rate in Drug Addiction and How to Naturally Prevent

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Gabapentin and Alcohol Dependence

October 3, 2014

Gabapentin Is Useful In Fighting Alcohol Dependence

gabapentinGabapentin also known to many as Neurontin is an anticonvulsant and analgesic drug. This drug was  originally developed to treat epilepsy however it also works well in relieving is neuropathic pain and is now used for pain relief in most hospitals worldwide. It is recommended as a first line agent for the treatment of neuropathic pain arising from diabetic neuropathy, post-herpetic neuralgia, and central neuropathic pain. This drug may also be prescribed for other off-label uses such as treatment of restless leg syndrome, anxiety disorders, insomnia, and bipolar disorder. There are, however, concerns regarding the quality of the trials conducted and evidence for some such uses, especially in the case of its use as a mood stabilizer in bipolar disorder. More research needs to be conducted to ascertain the use of this drug as a mood stabilizer in bipolar disorder.

 

 

Gabapentin Versus Chlordiazepoxide for outpatient alcohol

Benzodiazepines are used to treat alcohol withdrawal (AW) but they are known to cause cognitive impairment, sedation, and ataxia, and interact with alcohol. Nonbenzodiazepine anticonvulsants are promising and possibly safer alternatives for the treatment of Alcohol Withdrawal.

There several studies that have been conducted on this area especially comparing gabapentin and Chlordiazepoxide. In one of these studies the objective was to find out which of these two medications was safe and effective rather the objective was to compare the safety and effectiveness of these two medications. In this study the patients were divided into two groups. The first group was given gabapentin while the other group was given chlordiazepoxide. The subjects were then monitored after 7 days alcohol abstinence, withdrawal severity scores, adverse events including ataxia, sedation, cognitive function and alcohol craving. The results of this study however were never published. To others it may seem useless speaking about a study whose findings was not even published but the very existent of the research speaks volumes. For a fact it shows that chlordiazepoxide that had been used in the past in dealing with patients of alcohol withdrawal had some inefficiencies or had some serious side effects that needed to be corrected therefore a better medication was indeed needed to replace it. However, this is the authors own opinion lets proceed to other research studies that had been done on this subject.

There is also another study whose objective was to compare follow-up measures of Epworth Sleepiness Scale (ESS), Penn Alcohol Craving Scale (PACS), ataxia rating, and Clinical Institute Withdrawal Assessment for Alcohol revised (CIWA-Ar) symptoms between alcohol-dependent individuals randomized to treatment with gabapentin or chlordiazepoxide. In this study it was found that in ambulatory veterans with symptoms of alcohol withdrawal, gabapentin treatment resulted in significantly greater reduction in sedation (ESS) and a trend to reduced alcohol craving (PACS) by the end of treatment compared to chlordiazepoxide treatment. Although limited by the small sample size, the suggestion of reduction in sleepiness and less craving warrants replication of the study with a larger sample.

Gabapentin with Naltrexone for the treatment of Alcohol Dependence

In the fight to overcome alcohol dependence various strategies are used. In some cases a single drug maybe used successfully in fighting alcohol while in other cases two or more drugs may be combined for the same course to help fighting alcohol dependence more effectively. Gabapentin can be used singly to fight alcohol dependence but it can also be combined with naltrexone for more effective action against alcohol dependence.

There are some research studies that have been done on this subject and findings published. In a July 11, 2011 Raymond F. Anton, MD, professor of psychiatry at the Medical University of South Carolina, and colleagues reported their findings in the July issue of the American Journal of Psychiatry.

The report indicated that the addition of gabapentin to naltrexone improved drinking outcomes compared with naltrexone alone in heavy drinkers during the first 6 weeks after they stopped drinking, but when the gabapentin was stopped the effects became the same in both groups, so this shows that gabapentin was indeed responsible for the positive effects.

“From work in mice and rats we know that the underlying biology of alcohol dependence, particularly alcohol withdrawal, is mediated by two neurotransmitters — GABA [gamma-aminobutyric acid] and glutamate. Alcohol use causes these neurotransmitters to be abnormal and, particularly during alcohol withdrawal, to cause significant symptoms,” Dr. Anton told Medscape Medical News.

“We knew that the drug gabapentin works through these systems to normalize the balance of the glutamate and GABA systems in the opposite direction to what alcohol does, and we had done previous studies with gabapentin in mice and in humans showing that it reduced the symptoms of alcohol withdrawal. That led to our hypothesis that using gabapentin, particularly during the first 6 weeks of attempts at abstinence, might improve the efficacy of naltrexone,” he explained.

gabapentineThis study used randomly selected 150 alcohol dependent individuals who were put on a 16-week course of naltrexone, 50 mg/d alone; naltrexone, 50 mg/d, plus gabapentin up to 1200 mg/d for the first 6 weeks; or to double placebo. They also received medical management. Most of these participants were in their mid-forties. They were dependent on alcohol and drank 12-13 alcoholic drinks per day before the study entry. By week 6, about 50% of the individuals randomly assigned to placebo or naltrexone alone had a heavy drinking day, compared with about 35% of individuals who got naltrexone plus gabapentin. But by week 16 of the study, there were no differences between the groups. This show that gabapentin works better when combined with naltrexone than when naltrexone is used alone.

Dependence on alcohol and drugs is vice that has crippled societies and that is why here at AWAREmed we are dedicated to finding the best solutions to addiction and dependence on substances. Dr. Dalal Akoury (MD) is always in the mood of helping any patient to be addiction free. Do not hesitate to call on her for help in managing any sort of chronic pain as well as other diseases.

Gabapentin Is Useful In Fighting Alcohol Dependence

 

 

 

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Using Naltrexone To Treat Addiction Relapse

September 19, 2014

Using Naltrexone To Decrease Alcohol Relapse

Annually, around 1.5 million people in the USA seek treatment for alcohol and its related problems. In 1994, naltrexone became approved for the treatment of alcoholism by the U.S. FDA. Naltrexone works by blocking opioid receptors found in the brain as well as stemming the endorphin-mediated reinforcing effects of drinking alcohol. There is great  evidence to suggest and prove  that naltrexone has power to significantly reduce alcohol relapses to heavy drinking, the frequency of drinking, quantity of alcohol consumed  by  those who do drink, and also alcohol craving. Naltrexone is vitally beneficial in helping those patients who cannot abstain so as to reduce their drinking patterns, breaking the vicious self-destructive cycle of alcoholics which causes one to drink one drink which leads to the other together with allowing more quality time for psychosocial therapy to be productive. Naltrexone has demonstrated efficiency in a various alcohol-treatment settings using adjunctive psychosocial therapies that provide patients with motivation to stay in treatment, overcome relapses, and also take medications. Individualized and flexible naltrexone dosing can be of great benefit. Longer-term naltrexone therapy exceeding more than three months may be most effective, and naltrexone might be used on an as-needed, “targeted,” basis indefinitely. Alcohol is a very complex substance that affects several chemical systems in the brain.  It is presumed that, when an alcoholic drinks, the brain’s opioid system releases endorphins that trigger the reinforcement that is responsible for enticing one to drink more. Unlike other drugs that were earlier used to treat alcoholism, naltrexone is not addictive in nature and composition and does not in any way react aversively with alcohol.

Natraxene

·        Monthly naltrexone injection to control alcoholism

A monthly dose of Naltrexone, under different trade names, is already in use to treat alcoholism. The monthly dose is   a more convenient approach than current daily oral doses. Using naltrexone combined with counseling could help reduce heavy drinking in people suffering from alcoholism. Because of problems with adhering to daily oral doses of naltrexone, the effectiveness found in treating alcohol dependence with a once-a-month injection of naltrexone improves long-term treatment results. According to a previous study in 2005, naltrexone showed efficiency for treatment of alcohol dependence. However, adherence to daily oral doses can be hectic, and therefore, utilization of oral naltrexone have been limited.

·         Naltrexone should be used with caution in patients with liver disease

For a person suffering from hepatitis or liver failure, naltrexone should not be prescribed.it is recommended that liver function tests such as ALT, AST, gamma glutamyltransferase and bilirubin must be conducted before naltrexone treatment begins and at intervals after the treatment begins. In healthy patients without liver disease, intervals of 1, 3, and 6 month scan be ideal for the tests, then yearly thereafter. Liver function tests should be performed more frequently especially if baseline liver function test results are high, a history of hepatic disease is confirmed, or if a potential hepatotoxic medication is prescribed and if the patient is taking doses higher than 50 mg/day. Naltrexone should be used cautiously in patients whose serum aminotransferase results are greater than five times the upper limit of normal. 

  • Cannot be used for people using opioid for pain management

A careful drug use history and urine toxicological screening should also be done so as to confirm abstinence from opioids, including prescribed pain medications, as well as a lack of opioid dependence before initiating treatment. Comprehensive urine tests should be carried out to measure methadone and other opioids. However, urine testing can be subject to error because typical urine screening tests may not cover all opioids and samples can be tampered with to affect the results.

It is important to note that Administration of naltrexone should not be initiated until the patient has been opioid-free for between 7 to 10 days and that the naloxone challenge test for opioid withdrawal is negative. If no abstinence signs are observed following a preliminary dose of naltrexone 25mg, the rest of the daily dose is administered. Maintenance treatment regimen with naltrexone can be flexible where patients may receive naltrexone 50mg on weekdays and 100mg on Saturday or 100mg every other day, or 150mg every third day. Naltrexone is not suitable for use in patients with acute hepatitis or liver failure and should not be used in patients receiving opioid analgesics. The major active effect of naltrexone is on opioid drugs, which is one class of drugs used primarily to treat pain but is also found in some prescription cough preparations. This is because Naltrexone will block the effect of normal doses of this type of drug. There are many non-narcotic pain relievers that can be used effectively while you are undergoing treatment with naltrexone. Anyway, naltrexone is likely to have little impact on other medications patients commonly used in patients such as non-opioid analgesics (e.g., aspirin, acetaminophen, and ibuprofen) and antibiotics, and allergy medications.one should inform a physician of whatever medication he or she is currently taking so that possible interactions can be examined. Since naltrexone is metabolized by the liver, treatments that affect liver function may influence the dose of naltrexone.

naltrexone

A point to note is that naltrexone neither reduces the effects of alcohol that impair coordination nor judgment. Also Naltrexone’s effects on blocking opioids occurs shortly after the first dose is administered. Furthermore, findings confirm that the effects of naltrexone in helping patients remain abstinent and avoid relapse to alcohol use also occur early. However, Naltrexone should not be used with expectant women, people with liver or kidney damage or with patients who cannot practice abstinence for at least 5 days prior to commencing treatment. Also, people who are dependent on opioids such as heroin or morphine must cease their drug use at least 7 days prior to starting naltrexone.

Other than side effects, which are usually for a short period as well as mild, patients normally report that they are unaware of feelings of being on this medication. Naltrexone usually has no psychological effects and patients do not feel funny. It is also not addictive. While it reduces alcohol craving, it does not interfere with the experience of other types of pleasure.

Using Naltrexone To Decrease Alcohol Relapse

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