Tuesday, October 4, 2022

Which Doctor To Consult For Alcohol Addiction

Withdrawing From Alcohol Safely

Ask the Doctor 693a: Alcohol Use Disorder

When you drink heavily and frequently, your body becomes physically dependent on alcohol and goes through withdrawal if you suddenly stop drinking. The symptoms of alcohol withdrawal range from mild to severe, and include:

  • Headache
  • Trouble sleeping or concentrating
  • Elevated heart rate and blood pressure

Alcohol withdrawal symptoms usually start within hours after you stop drinking, peak in a day or two, and improve within five days. But in some alcoholics, withdrawal is not just unpleasantit can be life threatening.

If youre a long-term, heavy drinker, you may need medically supervised detoxification. Detox can be done on an outpatient basis or in a hospital or alcohol treatment facility, where you may be prescribed medication to prevent medical complications and relieve withdrawal symptoms. Talk to your doctor or an addiction specialist to learn more.

Seek emergency medical help if you experience any of the following withdrawal symptoms:

  • severe vomiting
  • extreme agitation
  • seizures or convulsions

The symptoms listed above may be a sign of a severe form of alcohol withdrawal called delirium tremens, or DTs. This rare, emergency condition causes dangerous changes in the way your brain regulates your circulation and breathing, so its important to get to the hospital right away.

The Brief Intervention: A Key Opportunity Too Often Lost

In addition to identifying people who need specialized addiction support, screening is important to help identify those whose alcohol use can be addressed by primary care providers. Many who drink above the low-risk guidelines may not be addicted to alcohol, but drink in ways that could affect their sleep, blood pressure and a host of other health issues, explains Kahan. To help this group, Canadas National Alcohol Strategy recommends whats known as brief interventions by health professionals.

According to Sheryl Spithoff, a family and addiction medicine doctor at Womens College Hospital Hospital in Toronto, a brief intervention can be five to 20 minutes. It involves saying Im concerned that youre drinking more than the low-risk guidelines and asking questions to help patients recognize any health effects or social effects they might be experiencing, she says. Often, patients dont recognize that their drinking poses a health risk and the conversation can be a wake-up call.

The evidence shows that brief interventions can be effective. One review found they helped a group of people who drank 22.5 drinks a week on average to reduce that by about three drinks a week. Another review found the reduction effect is far greater when brief interventions are targeted at mild and moderate alcohol use disorders.

Canadas National Alcohol Strategy recommends screening and brief interventions in community or walk in clinics and even the emergency room.

Questions To Ask An Alcohol Rehab Center

As for speaking to someone at a specific treatment center, questions you might want to ask could include:

  • Do you offer evidence-based treatment? This shows you that the facility uses treatments and makes decisions about a persons care that are consistent with the current best evidence published in peer-reviewed scientific studies.

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Should I Call An Alcohol Hotline

The decision to finally get help for an alcohol addiction is a brave step toward regaining control of your life. Even if youre unsure or scared about calling an alcohol addiction hotline, theres no harm in speaking with someone about your concerns. And chances are, youll be glad you did.

Addiction is complex and complicated, and it leaves people feeling confused and frustrated. Calling an alcohol hotline can add clarity and confidence about your next steps toward starting treatment.

Please note that while alcohol helplines are trusted resources, they cannot offer emergency care. If addiction and substance use has led to a medically or mentally dangerous situation, call 911.

Ways To Get In Contact With Us

beginningstreatment

If you believe you or someone you love may be struggling with addiction, let us hear your story and help you determine a path to treatment.

There are a variety of confidential, free, and no obligation ways to get in contact with us to learn more about treatment.

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Five Steps To A Sober Lifestyle

  • Take care of yourself. To prevent mood swings and combat cravings, concentrate on eating right and getting plenty of sleep. Exercise is also key: it releases endorphins, relieves stress, and promotes emotional well-being.
  • Build your support network. Surround yourself with positive influences and people who make you feel good about yourself. The more youre invested in other people and your community, the more you have to losewhich will help you stay motivated and on the recovery track.
  • Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When youre doing things you find fulfilling, youll feel better about yourself and drinking will hold less appeal.
  • Continue treatment. Your chances of staying sober improve if you are participating in a support group like Alcoholics Anonymous, have a sponsor, or are involved in therapy or an outpatient treatment program.
  • Deal with stress in a healthy way. Alcohol abuse is often a misguided attempt to manage stress. Find healthier ways to keep your stress level in check, such as exercising, meditating, or practicing breathing exercises or other relaxation techniques.
  • Substance Abuse Treatment For Doctors

    Substance abuse treatment provides a unique opportunity to engage in specialized medical care, such as individual counseling, group work, psychoeducation, complementary therapies, and care for trauma and co-occurring mental health issues.15

    PHPs do not actually provide treatment for SUDs. Instead, these programs provide case management for physicians.3 If treatment is deemed necessary after an assessment, the PHP draws up a contract lasting 1-5 years .3 This contract generally keeps the physician safe from prosecution and professional consequences if they successfully complete the program.3

    These contracts typically require total abstinence and participation in a 12-step program. Beyond that, effective treatment looks different for each physician and considers the substance used and the unique needs of the individual.3 Rehab may draw on a variety of treatment types, including:

    Studies indicate that PHPs are effective in this approach.16 In one such study, 64% of the 904 physicians in 16 PHPs competed their five-year contract without incident.16 The same research found 78% of the physicians licensed and working again five years later.16

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    What To Expect After Your Talk

    Once youâve told your doctor about your drinking, they will:

    • Ask you more questions about your drinking habits. They may also want to speak with members of your family.
    • Do a physical exam and take a detailed medical history.
    • Use lab and imaging tests to see if your drinking has caused organ damage.
    • Do a psychological evaluation to check how your drinking might affect your emotions and behavior.
    • Arrange follow-up appointments to check on your progress to help you ease your alcohol use, or stop it all together.

    From there, your doctor may:

    • Talk about how drinking affects you
    • Guide you to available treatment options
    • Give you tips to use in your day-to-day life that can help you cut back
    • Discuss your outlook
    • Refer you to mental health or AUD specialists who can help you make changes when youâre ready.

    Q& as For Doctors With Addiction Specialties

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    Below youll find 10 recommended questions to ask doctors who have a specialty in addiction. We also offer best case answers to listen for. These Q& As will help you find a provider with signs of higher-quality care that is a good fit for your situation.

    When you call a doctor, you may wish use the 10 Questions worksheet in the Toolkit. It can help you keep track of the questions and capture the answers.

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    Residential Or Inpatient Rehab Services

    Inpatient or residential AUD treatment entails patients living and residing in the rehabilitation center 24/7. Inpatient alcohol rehab may vary in duration, sometimes consisting of short stays of 36 weeks which may or may not be followed by attendance at an outpatient rehab. Some people require longer stays of 612 months at facilities known as therapeutic communities , which provide highly structured programming and offer assistance with reintegration into their community.

    Inpatient and residential rehab stays are beneficial because they remove a person from distractions and environments where they may be surrounded by people, places, or events that can trigger an alcoholic relapse, allowing them to focus solely on their recovery and building the necessary coping skills to live life as a sober person. Here, patients also receive around-the-clock care and monitoring, which helps address any post-acute withdrawal symptoms and offers necessary support.7

    Do You Get Restless When You Cant Drink Alcohol

    Restlessness and irritability when you cant drink alcohol are withdrawal symptoms. If you stop drinking or werent able to get your drink for some time, then you may experience such symptoms. You may also vomit, have cold sweats, and even experience depression. Observe yourself if you experience any of these withdrawal symptoms because they can be dangerous for you, even deadly. Immediately seek medical attention.

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    How We Doctors Are Failing Our Patients Who Drink Too Much

    The middle-aged man in my exam room wasnt an alcoholic. At least, thats what he declared to me as I asked him questions about his drinking.

    “Im not like those people,” he said, smiling nervously. “I go to work. I dont fall down the stairs. I dont embarrass myself.”

    As we spoke further about the consequences of drinking six to seven beers every night , he kept pushing back. I just need to relax. Im stressed at work and at home. Moneys tight. Im like everybody else. Im normal.”

    As the fourth-leading cause of preventable death, killing an estimated 88,000 Americans a year, alcohol is the most common problem that I encounter as a primary care doctor, and the one that I feel least able to manage. My ineffectiveness is all the more frustrating as addiction deaths continue to rise, contributing to the first drop in the American population’s life expectancy in generations.

    With all of our incredible medical advances, we have utterly failed to combat the growing plague of addiction. And while opioid disorders are gaining more attention, alcohol still kills more people than all illicit drugs combined.

    The first obstacle we have to face is a fundamental misunderstanding of the problem itself.

    An Alcoholic By Any Other Name

    When I began medical school, this categorical thinking was perpetuated by an unscientific classification of alcohol use in the medical community as abuse or dependence .

    How Much Is Too Much?

    A Glass Of Wine A Day Keeps The Doctor Away

    What Are The Causes Of Alcohol Addiction

    Alcohol and Nicotine De

    Some of a persons risk in developing an AUD depends on how much, how often, and how quickly they consume alcohol. Certain biological, psychological, and social influences are also believed to play a role in the development of AUDs. Some risks factors that may lead to someone developing an AUD may include:1,4

    • Genetics.
    • A family history of alcoholism.
    • Parental drinking patterns.
    • Exposure to trauma and stress during childhood.
    • Drinking alcohol at an early age. Scientists have found that people who began drinking at age 15 or younger were 5 times more likely to develop an AUD than those who started drinking at age 21 or older. In addition, the risk for females among this group is higher than for males.

    Certain psychiatric disorders, including major depression, bipolar disorder, anxiety disorders, and anti-social personality disorder are commonly associated with alcoholism, although whether or not these co-occurring disorders are a result of alcoholism or contributed to the development of an alcohol use disorder is unclear and may differ per individual. Some studies suggest that schizophrenia, depression, and personality disorders are also predisposing factors for AUDs. This means that if a person has one or more of these psychiatric conditions, they may have an increased risk of alcoholism.5

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    Behavioral Therapies For Alcohol Abuse

    Inpatient and outpatient treatment both provide various types of behavioral therapies that are commonly used to treat AUDs. These therapies may include individual and group therapy sessions as follows:11

    • Cognitive behavioral therapy, which is an evidence-based form of therapy that focuses on helping people identify and change unhelpful, negative thoughts and behaviors that led or contributed to their addiction. In CBT, people learn healthier ways to cope with stress and develop skills theyll need to prevent relapse.
    • Motivational enhancement therapy is a short-term therapy designed to help motivate patients to reduce or stop drinking and to encourage them to make positive changes. It helps patients identify the pros and cons of treatment, make a plan to change, increase their confidence, and ] develop the skills theyll need to stick to their recovery-related goals.
    • , is a form of talk therapy that incorporates a patients loved ones into their therapy sessions, if appropriate for a patient. Those who suffer from substance use disorders often directly or indirectly impact their closest relationships, so this form of treatment can help repair and rebuild relationships with patients loved ones, while also addressing issues that may have developed as a result of a persons drinking.
    • Brief alcohol interventions may include short, individual counseling sessions that provide people with personalized feedback on their progress with specific goals.

    Programs For Indigenous Peoples

    Support for Indigenous peoples

    • Help for First Nations and Inuit aimed at reducing high levels of alcohol, drug, and solvent use
    • Access to substance use treatments centres
    • Immediate help, including counselling and crisis intervention, to all Indigenous people across Canada 24 hours a day, 7 days a week in English, French, Cree, Ojibway, or Inuktitut
    1-855-242-3310
    • Thunderbird Wellness is a free app that provides access to an Indigenous perspective on health and wellness, where culture forms the foundation
    • Find information to help with substance use, addiction or mental health issues
    Download the Thunderbird Wellness App for free from the Apple Store for IOS users or for Android users
    Get naloxone
    • Take home naloxone kits are available through pharmacies. A prescription is not required. Ask the pharmacist. Some provinces offer free take-home naloxone kits.
    • Kits are available at public health units and social service organizations
    • St. John Ambulance offers free training and Take Home Naloxone Kits
    • Nasal naloxone is available for First Nations and Inuit clients covered by the Non-Insured Health Benefits Program
    Check your local pharmacy for more information Visit the Canadian Mental Health Association’s Naloxone 101 Toolkit to find out how, why and when to use a naloxone kit and where to get one for free Contact St. John Ambulance here Visit your local pharmacy, health centre or nursing station for more information

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    Why Do Some People Become Alcoholics

    It comes down to a complex combination of genetics, culture and socialstandards.

    Alcohol addiction is known to run in families and you may find that each generation gives the same justification for drinking. While genetics plays an important role, there is also the social influence to take into account. Across western cultures, alcohol is readily available and binge drinking is widely accepted. The act of being drunk is associated with celebrations and we use it to relax and enjoy ourselves even if we cant remember it the next morning! Youll often notice that we all look for reasons to drink, whether to celebrate or because we are sad, we find an excuse to have a drink.

    Its impossible to pinpoint one reason why people turn to excessive alcohol use, but the rewarding effects of drinking can be largely responsible. Its well known that alcohol boosts someones mood when they are feeling down and relaxes someone when they are feeling anxious. It is for this reason that people with high stress, anxiety or depression are more vulnerable to developing alcohol addiction. Its important to note that alcohol addiction is a real disease and a person with this addiction may not be able to control themselves and stop drinking.

    Accepting Slips Or Relapses

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    Nobody is perfect, and slips and relapses happen. In our recent survey only 29.4% reported not relapsing at all. The largest group relapsed back to alcohol use within the first year after stopping. Whats important is what you do after a slip or relapse. You need to get back on track. It sounds easy now, but guilt, shame, or the opinions or statements of others at the time may tell you otherwise. Dont fall into the trap! Everybody makes mistakes. Seek help and support from your support system and get back on track.

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    Statistics On Substance Abuse In Doctors

    Long hours and stressful working conditions may cause some physicians to turn to drugs or alcohol to cope. Some of the key findings in this area include:1-5

    • SUDs seem to be most prevalent in emergency physicians, studies report. Research suggests that somewhere between 7% and 18% of the physicians treated for SUDs in PHPs are emergency physicians.
    • Emergency room physicians and anesthesiologists are 3 times more likely to develop a SUD than other physicians.
    • Anesthesiologists with SUDs tend to relapse, overdose, or commit suicide at higher rates than other specialty physicians with SUDs.
    • Many physicians diagnosed with substance dependence have a history of prescription drug misuse. One study found that 69% of the physicians being monitored for substance-related impairment admitted to misusing prescription medications.
    • Physicians enrolled in PHPs do well. Studies indicate that 5 years after treatment, 75% to 90% still abstain from alcohol and other substances.
    • Most physicians return to practicing medicine without restrictions after treatment. In one observational study that followed more than 900 physicians from PHPs in 16 different states for 5 years, 72% of physicians went back to work.

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