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Alcohol Dependency and Abuse

Alcohol Abuse can be overcome: Free advice – ask me today!

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By Dr Mike Webberley  MBChB FRCP MD | GMC no. 2620107

I am a Consultant Physician with special interests in General Internal Medicine, Gastroenterology and liver disease. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.

Alcohol Dependency and Abuse

 

Alcohol addiction, although common for centuries, has become of particular concern in the last 50 years, mainly because of the impact on health, the family structure, work, finances, medical services and the real risk of self harm and suicide.

Until recently there has been very little the medical profession has been able to do, other than offer support and counselling, with referrals to alcohol and addiction charities.

However there are a new group of drugs that are able to combat the cravings of alcohol addiction, which are extremely safe, without any unpleasant side effects and which are recommended by NICE.

We have expertise with working with these medications and are able to offer treatment in combination with psychological support and counselling. In addition we can provide a comprehensive liver screen which will help to predict your future health.

Frequently Asked Questions

Why do I have an alcohol addiction?
This can be very complicated. In some people there is a genetic component and some races are more prone to alcoholism than others. This probably accounts for about half of the people with alcohol addiction. The other half is due to learned behaviour from parents and society, societal and peer pressures, availability, stress and ‘addictive personalities’. This latter group are often also smokers and gamblers.

How does alcohol damage my liver?

Alcohol is toxic to the liver, causing damage to the liver cells (hepatocytes). The first sign of alcohol damage to the liver is the development of fat globules within the hepatocytes. This is called fatty liver or steatohepatitis and is reversible with abstinence of alcohol. Continued alcohol consumption results in those cells dying and being replaced intially by other liver cells but ultimately by scar tissue (fibrosis).The liver is extremely good at repairing itself but over a period of many years as more scar tissue gets laid down, the liver becomes encased in a rigid network of fibrosis and can no longer expand and repair itself. This is called cirrhosis and is associated with a 50% mortality over 5 years, if the person continues to drink.

How does alcohol affect my other organs?
  • Brain – Alcohol causes progressive deterioration of the brain and is the second most important cause of dementia. It also causes serious psychiatric illness such as depression, anxiety, bulimia, panic attacks and personality disorders.
  • Heart – Over a period of time, alcohol causes damage to the walls of the chambers of the heart (ventricles). The heart becomes less effective as a pump and the body starts to retain fluid. This is called heart failure.
  • Pancreas – After a binge, alcohol can cause acute pancreatitis, a destructive inflammatory process, damaging the pancreas. This is a medical emergency and has a high mortality. Over a period of time, alcohol causes a slow destruction of the pancreas. This can lead to diabetes, malabsorption, severe and often untreatable pain and chronic diarrhoea.
Does alcohol damage my health?

Unfortunately alcohol can have a severe impact on your health. Apart from the destructive effects on your work, your family structure and on your children, alcohol excess can cause serious and potentially fatal medical problems. The main 4 organs that are damaged by alcohol, are your liver, your brain, your pancreas and your heart.

What else do I need?

 

Before treatment can be started, it is really important that you are committed to reducing your consumption or stopping altogether. We will usually ask you to abstain for 2 weeks prior to starting treatment. This will often require the full support of your family while you embark on treatment, but also continued support from charities and also even cognitive behavioural therapy (CBT), counselling and hypnotherapy. Treatment will last at least 6 months but longer if necessary and some patients may need treatment for many years because of the high risk of recidivism (starting alcohol again).

 

Are there tablets I can take to stop me drinking?
Yes, fortunately there are new types of medication that can be taken to stop the cravings of alcohol addiction. They tend to be safe with very few unpleasant side effects and are often very effective. They need to be taken under medical supervision. They include Nalmefene, Naltrexone and Acamprosate. The older types of medications often induced unpleasant symptoms when taken with alcohol such as Disulfiram (Antabuse) and are now prescribed much less frequently. We are able to offer all of these treatments under the right circumstances.

 

Medication

Acamprosate

Acamprosate is usually started after an initial withdrawal period of 2 weeks. It seems to work by stabilising the chemical imbalance in the brain that would otherwise be disrupted by alcohol withdrawal. The usual dose is 6 tablets a day and to be taken for at least 1 year. It is very safe with no significant interactions with other medications and the only real side effects are diarrhoea and abdominal pain and some skin irritation.

Naltrexone

Although in general terms, Naltrexone is very safe, the main concern is that patients who are also addicted to opioids (such as Heroin, Co-codamol, Co-dydramol) may experience acute withdrawal which may be extremely dangerous. We normally recommend a 2 week abstinence period before starting treatment so that acute withdrawal symptoms do not occur. Otherwise it is safe and effective and needs to be taken for at least 6 months but usually much longer.

Nalmefene

Nalmefene is also very safe with few serious side effects and drug interactions. Patients taking Nalmefene may experience decreased appetite, poor sleep, dizziness, headaches and palpitations. After an initial monitoring period of 2 weeks, it can be started at a dose of 1 tablet taken 1 to 2 hours before alcohol consumption is likely to start. It may be needed to be taken for many years.

Safe, real prescriptions to help you

Whether you know what treatment works for you or you need advice on what you should take,

ask me here about safe prescriptions to help with your condition.

Tests and Investigations

Comprehensive blood screen

This would include a full blood count, liver and kidney screen, gamma GT, cholesterol profile, blood sugar, thyroid and cortisol. This would be used as a baseline for your future management with medication.

Ultrasound of the abdomen

This would be suggested in those patients who have abnormal liver tests on the initial screen. This would give us more useful information about the state of the liver, pancreas and other abdominal organs. This can be organised at your local private hospital.

Fibroscan

This is a new and sophisticated scan that detects the amount of early scarring or fibrosis in the liver. This detects early fibrosis and before the development of cirrhosis and so gives a very useful predictive idea about the risks of you developing cirrhosis. This can be arranged at your local private hospital.

Contact me now for advice, prescriptions, blood tests and referrals.

Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness.

It is never to be used in the case of a medical emergency.

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