Disulfiram treatment of alcoholism

Article Abstract:

The drug disulfiram (Antabuse) is used to treat alcoholism in patients who are free of alcohol, and current knowledge of therapy with this agent is summarized. Doses of 250 to 500 milligrams per day of disulfiram generally produces an aversive or unfavorable reaction to ethanol, although some patients may not develop an aversive reaction at that dosage. Patients should be aware of the adverse consequences of consuming alcohol when taking disulfiram; intense flushing, weakness, nausea, and sometimes low blood pressure. Disulfiram may also cause toxic effects on the heart, liver, and nerves. Physicians and patients must recognize the need for supervision to monitor the effectiveness and side effects of disulfiram therapy. Physicians should be aware that disulfiram is only an adjunctive therapy and must be combined with continued support, counseling, and other therapeutic measures. Disulfiram effectively decreases the frequency of alcohol consumption in patients willing to comply with therapy over a short period of time (about six months). Patients who are older, socially stable, and well-motivated may experience beneficial effects over a longer duration. However, supervision of disulfiram treatment over the short-term may be associated with practical problems and concerns that the supervising person may be placed in a difficult position. Disulfiram treatment should be combined with education, counseling, and alcoholism therapy in order to produce beneficial effects. The effectiveness of disulfiram on the long-term outcome of alcoholism has not been established. (Consumer Summary produced by Reliance Medical Information, Inc.)

Services, Complications and side effects, Physiological aspects, Drug therapy, Disulfiram

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Alcohol abuse: comparison of two methods for assessing its prevalence and associated morbidity in hospitalized patients

Article Abstract:

The effectiveness of two tests that screen for alcohol abuse and the prevalence of co-existing disease were assessed in 1,964 hospital patients. The screening tests included the CAGE questionnaire, which consists of four questions that address the perceptions of persons who abuses alcohol, and the Short Michigan Alcoholism Screening Test (SMAST), which assesses adverse psychological consequences of alcohol abuse. Alcohol abuse was diagnosed as a primary problem in 1.4 percent of patients, and as a secondary problem, or the result of another illness, in 6.0 percent. Alcohol abuse was detected by screening tests in another 15 percent of patients who had never been diagnosed with either primary or secondary alcohol abuse problems. Hence, alcohol abuse was prevalent in 22.4 percent of all hospitalized patients. The risk of dementia; chronic obstructive pulmonary disease, a condition resulting in impaired function of the lungs; pancreatitis, inflammation of the pancreas; liver disease; and illegal drug abuse was higher among patients diagnosed with alcohol abuse compared with patients without this diagnosis. The risk of high blood pressure, abnormal heart rhythms, breast cancer, and pelvic inflammatory disease, was higher among patients who tested positive for alcohol abuse. These findings indicate that alcohol abuse is widely underdiagnosed. The use of these tests for screening alcohol abuse would help to better identify affected patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Diagnosis, Medical screening, Health screening, Hospital patients

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Youthful precursors of alcohol abuse in physicians

Article Abstract:

Despite knowledge of its medical and social consequences, there is little information available on the cause of alcoholism. There have been few prospective studies designed to isolate traits that are predictors of alcoholism. This study was designed to identify precursors of alcohol abuse in physicians, and was based on 40 years of research on a group of 1,014 male medical students. These students, now physicians 52 to 68 years of age, were given an alcoholism screening questionnaire. Alcohol abuse was determined based on reported alcoholism, a score of two or higher on a screening questionnaire, or reports of drinking an average of four or more drinks per day. The results indicated that 12.9 percent of the doctors abused alcohol. The precursors identified in medical school that were later associated with alcoholism were: non-Jewish ancestry, lack of religious affiliation, smoking of one or more packs of cigarettes a day, regular use of alcohol, anxiety or anger as a reaction to stress, using alcohol frequently in nonsocial settings, past history of alcohol-related difficulty, and maternal alcoholism or mental illness. Characteristics that were unrelated to alcoholism were sleep habits, the use of controlled drugs, hobbies or sports, and parental relationships. There was no significant relationship found between chosen medical specialty and alcoholism. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Social aspects, Risk factors, Physicians, Medical professions, Alcohol use

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