The most effective comprehensive treatment method. Patients with alcoholism are treated on an outpatient and inpatient basis, at the request of patients and forcibly, in psychiatric and specialized drug treatment facilities.
In the treatment of alcoholism, several stages are distinguished: detoxification, relief of withdrawal symptoms, proper anti-alcohol and anti-relapse treatment. At each stage, measures of complex effects on the biological and psychological mechanisms of the disease are used. Often there is a need to remove the patient from acute alcohol intoxication, in the active interruption of binge.
The task of the initial stage of treatment is to prepare the patient for active anti-alcohol therapy. From the groups of drugs and mixtures listed in the scheme, combinations of those that are most appropriate for the patient’s somatic and mental state are selected.
In recent years, a positive therapeutic effect in the treatment of alcohol withdrawal from the use of hemipevrin (chlormethiazole), grandaxip, phenazepam, carbidine and piracetam (G.V. Morozov, N.N. Ivanets, 1980), as well as etaperazine, periciazine (non-aleptil) and clozapine (leponex). More effective than etaperazine and neuleptil, leponex (up to 100-150 mg per day), which, along with hypnotics and sedatives, also has an euphoric effect (V. B. Altshuler, 1980). Piracetam is recommended to take 2000-2400 mg per day for 6-7 days, or 1200-2000 mg for a longer time, especially with astheno-depressive and asthenic withdrawal symptoms in severe stages of alcoholism (L. M. Savchenko, 1980).
Some authors note that for stopping alcohol withdrawal, they successfully absorb sorbents (V. G. Nikolaev, V. M. Postrelko, 1982), perform acupuncture (R. A. Durinyan et al., 1980; I. K. Sosin, G. N. Mysko, 1982), electroacupuncture, hyperbaric oxygenation. R. A. Durinyan and co-authors (1980) indicated that one procedure is enough for the relief of alcohol withdrawal syndrome, less often – 2-3 procedures for acupuncture (the condition improves 10-15 minutes after the needles are inserted), and for the relief of alcohol delirium – 3- 4 treatments. However, the pathogenesis of alcohol withdrawal requires complex treatment, including drug and non-drug methods.
The purpose of the actual anti-alcohol treatment is to develop an aversion to alcohol in patients so that they stop drinking it. In stage I, less often – stage II of alcoholism, psychotherapy and the development of an emetic reflex for alcoholic drinks using emetics give a positive effect, in stage II-III the development of an emetic reflex and sensitization of the body with teturam in combination with psychotherapy, in stage III – sensitization with teturam, implantation of disulfiram (eperal, radoter). The duration of remissions depends on the environment, many factors of an individual, personal and professional nature. The duration of remissions is longer in the treatment of the initial stages of alcoholism and the desire of the patients themselves to cure. The anti-alcohol treatment in drug treatment facilities at industrial enterprises gives encouraging results, where there are conditions for the simultaneous use of drug treatment, psychotherapy, work processes and the use of the psychological atmosphere of a healthy production team. Until the lichnostno-important motive for the complete rejection of alcohol (for example, psychotherapeutic “coding”, according to A. R. Dovzhenko, 1986) is formed, therapeutic measures turn out to be futile. Attracting psychologists to study the condition of patients and their treatment (in individual and group psychotherapy) may be one of the most promising ways to increase the stability of alcoholic remissions.