Disulfiram for Alcohol Addiction Treatment
By Devanshi ChandwaniPosted on 20-12-2023 | 19:25
About Alcohol Addiction
Alcohol addiction or Alcohol Use Disorder (AUD) is a disorder characterised by the inability to control drinking and having dependence on alcohol. Those with alcoholism cannot stop the urge to drink alcohol. They consume more alcohol in a day than an average person, one even takes up to 8-10 drinks per day. It is a debilitating disorder, affecting all aspects of life like career, mental health, relationships, etc. One must win in the battle with addiction, and the following blog talks about medication.
Alcohol Addiction Treatment
De-addiction is tough because brain rewiring has to be done again. One has to learn to NOT give in to the cravings. Alcohol addiction treatment involves several methods, like medications, cognitive behavioural therapy, rehabilitation, aversion therapy, alcohol detoxification and self-abstinence, AA meetings, and more.
Among medications, effective ones include naltrexone, acamprosate, disulfiram, 
Statistics:
According to the American Psychological Association, alcoholism is a syndrome affecting millions worldwide. In India alone, about 2.5 million people suffer from alcohol dependence, with alarming rates of suicides linked to alcohol use disorder, as reported by the National Crime Records Bureau (NCRB).
Understanding Disulfiram: Mechanism of Action and Benefits
Disulfiram operates as an aversive conditioning agent, deterring alcohol consumption by blocking the enzyme responsible for alcohol breakdown. When an individual ingests alcohol while on disulfiram, it leads to an accumulation of acetaldehyde, a toxic substance, causing unpleasant reactions. This mechanism aims to create a strong negative association with alcohol, discouraging further consumption.
Key Benefits of Disulfiram:
1. Forced Sobriety: Users have reported that disulfiram forced alcohol out of the equation, alleviating the constant internal struggle of whether to drink or not.
2. Cognitive Impact: Users share that the medication has not only helped them overcome alcohol dependence but has also catalysed personal growth, with some expressing a feeling of "growing up" mentally.
3. Relief from Daily Struggles: One user mentioned, "I’m not consumed with the agony of contemplating whether I will or won’t every single second of every day. It’s painful, but a relief as well."
Dosage and Administration:
The recommended dosage of disulfiram varies based on the individual's needs and response to treatment. Initially, a daily oral dose of 500mg is prescribed for approximately 1-2 weeks. For maintenance, a 125-500mg tablet is taken once a day. However, it is crucial to consult a healthcare professional for personalised advice, as treatment duration and dosage may be adjusted accordingly.
Side Effects and Cautions:
Common side effects:
- Nausea and vomiting
- Dry mouth and throat, thirst
- Dehydration
- Sweating
- Dizziness, confusion
- Fatigue
- Blurred vision
- Rashes, skin irritation
- Neck pain
- Sexual dysfunction
- Chest pain, throbbing sensation
- Fast heartbeats
- Headache
- Psychosis
Go to emergency care at once if you experience these severe symptoms-
- Suicidal thoughts
- Sudden vision blackout
- Liver problems
- Jaundice
- Seizures
Avoid taking Disulfiram in these cases-
- You are in a state of alcoholic intoxication, under the effect of alcohol
- It has not been 12 hours since you last consumed alcohol
- You have been administered paraldehyde or metronidazole
- You have consumed products that have alcohol- mouthwashes, vinegar, cough syrup, or some desserts
- Hypothyroidism (underactive thyroid)
- Pregnancy
- Breastfeeding
- Susceptibility to extreme allergic reactions
- Cardiac (heart-related) problems
- Renal (kidney) and liver problems
- Diabetes
- You are on the psychosis or schizophrenia spectrum
User testimonials offer valuable insights into the efficacy and challenges of disulfiram in alcohol addiction treatment. Here are additional experiences:
User 1:
"It was a last resort for me as well. I have 73 days now. I don’t think there’s any way I could have made it this far without it. It really forced alcohol out of the equation, and I’m not consumed with the agony of contemplating will I or won’t I every single second of every day."
User 2:
"I love it. It’s exactly what I needed to kick the habit. I feel like I have 'grown up' 15 years in six months. I’m now really embarrassed for what I had allowed myself to become, and taking Antabuse reaffirms to me that this is serious, and drinking is never going to be an option ever again."
User 3:
"It was definitely the way out of the cycle for me. Before, my longest streak of sobriety outside of inpatient was 4 days or so. Those days were torture. It still sucks a lot of days, but doesn’t feel like torture the way it did."
Exploring the Long-Term Impact:
While disulfiram has shown promise in initiating and supporting sobriety, its long-term impact on individuals varies. Some users may eventually choose to transition away from disulfiram, while others find comfort and security in maintaining it as a crucial part of their ongoing recovery.
The State of Alcohol Addiction in India:
India faces a significant challenge with alcohol addiction, impacting millions across the country. Understanding the statistics is crucial in addressing this public health issue.
Since alcohol is so commonly available, it is one of the most widely used substances. An alcoholic drink contains ethanol (C2H5OH). The sugars present act as the drug. Alcoholism is a real disease. Alcohol causes various problems like diabetic complications, ulcers, sexual problems, bone loss, birth defects, vision problems, increased risk of cancer and suppressed immune function. It impairs an individual’s neurochemistry. It may also bring suicidal tendencies in a person who is struggling.
NFHS-5 report states that alcohol consumption among men in India has decreased by 7% since 2015. NIMHANS director Pratima Murty, who was part of a study that found that excessive alcohol consumption can cause irreversible changes to the DNA and the changes may persist even when it is no longer consumed, said that the reduction in consumption could also be due to the unavailability in the lockdown period due to COVID-19 (as the report is for 2019-2021).
According to a UBS report, India’s per capita alcohol consumption is much lower at 5.5 litres as compared to the global average of 6.2 litres. Arunachal Pradesh has the highest proportion of both men (53%) and women (24%) who drink alcohol. Among women who drink alcohol in India, 17% consume it almost every day and 37% drink almost once a week. Among men, while 15% drink almost daily, 43% drink about once a week and 42% do less than a week. Since the prohibition in Bihar, 1.6 crore people have quit alcohol.
According to a study by the World Health Organization (WHO), about 2.5 million people in India suffer from alcohol dependence. Data from the National Crime Records Bureau (NCRB) shows that as many as 10,560 suicides happened in 2021 due to alcohol use disorder and substance abuse.
There are various methods of treatment that help in recovery like rehabilitation centres, guided counselling, nutritional changes, medication prescribed by psychiatrists. Even support groups like Alcoholics Anonymous help. They have 12-step programmes, and each alcoholic has an assigned sponsor/mentor who helps him in his journey to recovery. It should be noted though, that these treatments do not account for permanent stability. People relapse too. They may stay sober for a while then start drinking again. It also depends on the will of the person to become sober apart from the quality of rehabs and doctors. It is said that the alcohol addiction of an individual makes him as well as the whole family suffer. Thus, there is a programme in AA for the family members of the alcoholics too: AlAnon. Sobriety is the responsibility of a person who consumes alcohol.
Conclusion
Disulfiram stands as a valuable tool in the comprehensive arsenal against alcohol addiction. Its mechanism of action, coupled with user testimonials, suggests that it serves as an effective deterrent, helping individuals break free from the cycle of alcohol dependence. While disulfiram is not a one-size-fits-all solution, the positive experiences of those who have incorporated it into their recovery journey underscore its potential significance. However, it is essential to approach disulfiram with caution, considering the associated side effects and contraindications. Consulting with a healthcare professional is crucial to determine the appropriate dosage and duration of treatment tailored to an individual's unique circumstances.
In conclusion, disulfiram represents a promising option for those seeking to overcome alcohol addiction, offering a pathway to sobriety by disrupting the ingrained patterns of alcohol consumption. As part of a comprehensive treatment plan, disulfiram can contribute to rewiring the brain and fostering lasting recovery, providing hope for individuals battling the challenges of alcoholism.
Treating alcoholism requires a multi-faceted approach. In India, Remint Health has emerged as a comprehensive service provider, offering an array of treatments from medications like Naltrexone and Acamprosate to specialised counselling services. For those navigating the complexities of alcoholism treatment, options like medication, the Sinclair Method, and Remint Health's customised plans offer valuable pathways to recovery. It’s essential to consult a healthcare provider for proper diagnosis and treatment planning.
Remember, there is hope for all. You are not alone in this journey. Choosing to win over the addiction is tough, but so is staying in the loop. You and your family deserve to heal and be free from the shackles of addiction.
Disclaimer: Our articles and resources do not constitute clinical or licensed therapy or other health care services. If you need counseling or therapy services please contact a licensed provider. If this is a medical emergency, call 911.
About the Author
Devanshi Chandwani