Alcoholism is a broad term for excessive and addictive consumption of alcohol that leads to adverse health outcomes and social problems. The main implication of alcoholism and other opioid addictions is that individuals feel a continuous urge to consume a new dose, which is usually larger due to drug tolerance (Gale Research, p. 52). In order to stop the drinking problem and treat the alcohol-use disorder (AUD), successful intervention is needed. Taking into consideration that it is a brain disease, intervention should comprise an allopathic treatment approach and medication that helps to avoid relapse. Allopathic treatment of alcoholism is based on modern medicine and includes detoxification and recovery as its main stages. Nevertheless, such drugs have been used with variable success, and further research is needed. Despite the overall advance in treatment, alcoholism is still a challenge due to the lack of successful drug efficacy appraisals and pharmacotherapy personalization in patients with AUD.
Alcohol dependence and alcohol abuse are common AUD causes. According to Zastrozhin, 60% of AUD cases emerge due to genetic reasons, which is a high heritability rate (p. 132). More than 17 million US adults were reported to have drinking problems (Charting Alcohol’s Impact on America, p. 58). Face-to-face interviews with 44,000 of the US civilians indicated that self-reported alcohol dependence rate declined, and alcohol disorder rates were highest among young adults. Moreover, Kimbrough et al., in their research, found that mice’s functional architecture of brain modularity and activity was reorganized as a consequence of alcohol abstinence (p. 2155). It showed that particular parts of the brain are involved in alcohol addiction and how the whole-brain modularity is affected. Those findings may be applied to the human being because mice generally have almost a similar brain structure, but further research is needed. In general, alcohol changes the functional development of the cerebellum, cerebral cortex, and also prevents the formation of new synapses.
Adult children of alcoholics were believed to be AUD prone because of genetic heritage and childhood experiences, but analysis of previous studies showed that there is no enough evidence. According to Vail, the main researches on parental alcoholism and its impact lack the appropriate categorical approach and reliable knowledge base (p. 117). Nevertheless, the government needs to design appropriate health programs to prevent the initiation of drinking patterns during adolescence. It is crucial because continuous alcohol consumption causes addiction and adverse changes to health. For instance, AUD was estimated to result in more than 5% of total deaths in the world (Zastrozhin, p. 134). Excessive alcohol consumption usually leads to health problems within the cardiovascular, reproductive, gastrointestinal, and nervous systems.
Withdrawal states and acute effects such as nausea, seizures, hallucinations, agitation, and anxiety are clinical conditions that usually prevail in practice. These disorders often require pharmacological treatment in order to relieve discomfort or ovoid resuming to drinking. The list of common medications includes acamprosate, nalmefene, disulfiram, baclofen, naltrexone, topiramate, and gabapentin. All of them showed efficacy superiority over placebo in accordance with available studies.
Disulfiram effect can be enhanced by a reduced plasma D[beta]H level in patients who carry that biomarker. Moreover, disulfiram efficacy can be significantly affected by the polymorphism of the ANKK1 and DRD2 genes (Zastrozhin, p. 135). Naltrexone, together with acamprosate, is seen to help eliminate the effects of a relapse gradually. The assessment showed that acamprosate is effective and can be used to treat alcohol addiction. Nevertheless, the outcomes of the studies examining other medications are controversial, so there is a lack of evidence on its pharmacogenetics (Zastrozhin 137). In general, such medications have common adverse outcomes, including vomiting, nausea, headache, dizziness, and insomnia, while naltrexone even causes liver issues. Hence, some of them should be added to the treatment only as a last resort.
To conclude, alcoholism is still a huge medical problem because of its biological, genetic, emotional, and behavioral causes. Alcoholism treatment requires a comprehensive approach that includes special therapy and medication. Pharmacogenetic biomarkers have the potential to personalize treatment for every alcoholic and increase therapeutic efficacy, but the needed information is available only for naltrexone. Further research on the common medication efficacy is welcomed, while currently, some alcoholism medications should be applied only in case of emergency.
Works Cited
- “Charting Alcohol’s Impact on America.” Clinician Reviews, vol. 14, no. 7, 2004, p. 58. Web.
- Gale Research Inc. The Gale Encyclopedia of Alternative Medicine. 5th ed. Gale, 2019, pp. 52-60.
- Kimbrough, Adam, et al. “Brain-wide Functional Architecture Remodeling by Alcohol Dependence and Abstinence.” Proceedings of the National Academy of Sciences. vol. 17, no. 4, 2020, pp. 2149-2159.
- Vail, Mary Orosz, et al. “Sampling Issues in Research on Adult Children of Alcoholics: Adolescence and Beyond.” Adolescence, vol. 35, no. 137, 2000, pp. 113-119.
- Zastrozhin, M. S., et al. “Pharmacogenetics of Alcohol Addiction: Current Perspectives.” The Application of Clinical Genetics, 2019, p. 131-140.