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There are three oral medications that have been FDA-approved to help people remain sober: disulfiram, naltrexone, and acamprosate. They are prescribed for those who have indicated their intention to abstain from alcohol but require some reinforcement. Disulfiram causes unpleasant symptoms such as nausea, vomiting, and flushing with any amount of drinking. Naltrexone limits the cravings a person may get from drinking but can cause severe withdrawal symptoms in people who are also dependent on opiates. Acamprosate helps reduce the craving for alcohol. An injectable, long-acting form of naltrexone is also available. All of these medications are meant to be used in combination with counseling.
Because of the growing population of older Americans, the number of heavy drinkers will increase from 1 million currently to 2 million by 2060. [20] The 2012—2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC III) found that 55.2% of adults age 65 and over drink alcohol. Most of them don’t have a drinking problem, but some of them drink above the recommended daily limits. [21]
Though cautious regarding the medical nature of alcoholism, AA has let others voice opinions. The Big Book states that alcoholism "is an illness which only a spiritual experience will conquer." Ernest Kurtz says this is "The closest the book Alcoholics Anonymous comes to a definition of alcoholism."[60] In his introduction to The Big Book, non-member William Silkworth said those unable to moderate their drinking have an allergy. Addressing the allergy concept, AA said "The doctor’s theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little. But as ex-problem drinkers, we can say that his explanation makes good sense. It explains many things for which we cannot otherwise account."[61] AA later acknowledged that "alcoholism is not a true allergy, the experts now inform us."[62] Wilson explained in 1960 why AA had refrained from using the term "disease":
Our program focuses on the whole child, with the ultimate goals of abstinence, improved mental health and better family relationships. Our intensive outpatient program (IOP) is the only one in North Texas that offers this level of care specifically for teens. We incorporate medication management, cognitive behavioral therapy, motivational enhancement therapy, group and individual therapy, and family engagement to help your child gain valuable coping skills to end drug abuse, as well as manage emotional or psychological problems.
As with similar substances with a sedative-hypnotic mechanism, such as barbiturates and benzodiazepines, withdrawal from alcohol dependence can be fatal if it is not properly managed.[55][61] Alcohol's primary effect is the increase in stimulation of the GABAA receptor, promoting central nervous system depression. With repeated heavy consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. When alcohol consumption is stopped too abruptly, the person's nervous system suffers from uncontrolled synapse firing. This can result in symptoms that include anxiety, life-threatening seizures, delirium tremens, hallucinations, shakes and possible heart failure.[62][63] Other neurotransmitter systems are also involved, especially dopamine, NMDA and glutamate.[25][64]

Women develop long-term complications of alcohol dependence more rapidly than do men. Additionally, women have a higher mortality rate from alcoholism than men.[35] Examples of long-term complications include brain, heart, and liver damage[36] and an increased risk of breast cancer. Additionally, heavy drinking over time has been found to have a negative effect on reproductive functioning in women. This results in reproductive dysfunction such as anovulation, decreased ovarian mass, problems or irregularity of the menstrual cycle, and early menopause.[35] Alcoholic ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking.[37][38] The amount of alcohol that can be biologically processed and its effects differ between sexes. Equal dosages of alcohol consumed by men and women generally result in women having higher blood alcohol concentrations (BACs), since women generally have a higher percentage of body fat and therefore a lower volume of distribution for alcohol than men, and because the stomachs of men tend to metabolize alcohol more quickly.[39]
Risk factors for developing a drinking problem include depression, anxiety, or another mood problem in the individual, as well as having parents with addiction. Low self-esteem and feeling out of place are other risk factors for developing alcohol dependence. In women, antisocial behaviors and impulsivity are associated with the development of severe alcohol use disorder. Both men and women are more likely to develop alcoholism if they have a childhood history of being physically or sexually abused. Children and teens who have their first drink of alcohol between 11 and 14 years of age are more at risk for developing a drinking alcohol problems than those who do so when either younger or older.
The first step in the treatment of alcoholism, called detoxification, involves helping the person stop drinking and ridding his or her body of the harmful (toxic) effects of alcohol. Because the person's brain and body has become accustomed to alcohol, the alcohol-dependent person will most likely develop withdrawal symptoms and need to be supported through them. Withdrawal will be different for different individuals, depending on the severity of the alcoholism as measured by the quantity of alcohol ingested daily and the length of time the patient has been alcohol dependent.
Clear communication by parents about the negative effects of alcohol, as well as about their expectations regarding drug use, has been found to significantly decrease alcohol use in teens. Adequate parental supervision has also been found to be a deterrent to underage alcohol abuse. Alcohol, and other drug use, has been found to occur most often between the hours of 3 p.m. and 6 p.m., immediately after school and prior to parents' arrival at home from work. Teen participation in extracurricular activities has therefore been revealed to be an important prevention measure for the use of alcohol in this age group. Parents can also help educate teens about appropriate coping and stress-management strategies. For example, 15- to 16-year-olds who use religion to cope with stress tend to use drugs significantly less often and have fewer problems as a result of drinking than their peers who do not use religion to cope.
A twelve-step program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism,[1] the Twelve Steps were first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.[2] The method was adapted and became the foundation of other twelve-step programs.
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