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Posted: Monday, September 22, 2014

Diagnosing and treating alcohol use disorders

Many of us can relate to alcohol use disorders. In fact, it’s safe to say a good number of us also are related to someone who has had experiences with alcohol use disorders. Sometimes called alcohol dependence or alcoholism, alcohol use disorders are not necessarily about the amount a person drinks. Often it is about the loss of control that person experiences when he or she is drinking. This can lead to negative consequences such as missing work or school due to drinking; arguing with family and friends; and medical or legal problems. When a person struggles to cut down or stop drinking in spite of these problems, he or she may need to seek help.

Psychiatrist Dr. Julia Wood from Blount Memorial Parkway Psychiatric Service says there are recommended limits on alcohol use. “For women, the Centers for Disease Control and Prevention (CDC) recommends no more than seven drinks per week and no more than three drinks in a single occasion. For men, those numbers are no more than 14 drinks per week and no more than four in a single occasion,” Wood explained. “I try to educate my patients about these limits and encourage them to stick to them because drinking more than this on a regular basis can have negative impacts on their health,” she added.

Wood says alcohol use disorders often are self-diagnosed. “Frequently, people will seek help if they feel that alcohol is interfering with their lives, or when they feel they can’t stop using it without help,” she said. “It can’t be understated how valuable support groups such as Alcoholics Anonymous (AA) are in helping people overcome alcohol use disorders; however, there are pharmacological treatments for alcohol use disorders that also have been proven to be effective. We now have medications, such as naltrexone and ecamprosate, which not only can reduce alcohol cravings, but also can reduce time one spends drinking if a relapse does occur. Any physician who has experience treating alcohol use disorders can prescribe these medications, but more often, it is psychiatrists who end up prescribing them for patients. Sometimes, people find access to these medications by participating in programs designed to help them maintain sobriety,” she explained. “With these specific medications, there is no concern about shifting a patient’s alcohol addiction to an addiction to the medications. However, people in recovery from alcohol use disorders often are advised to avoid using certain pain or anxiety medications due to the risk of addiction,” she added.

“Not everyone needs a medication to support sobriety,” Wood said. “However, it is important to note that, depending on the amount and frequency a person has been drinking, it actually can be unsafe to simply stop drinking altogether due to the possibility of withdrawal symptoms, some of which can cause seizures or even death. Often, people experiencing withdrawal symptoms are monitored and treated in the hospital, so that we can treat their symptoms with medications to prevent any potentially dangerous complications,” she explained. “For anyone who wants to stop using alcohol, AA and your primary care doctor can be a great place to start. AA has been helping people stay sober for decades without medication or formal psychotherapy. Still, many people simply try to tough it out without considering medications that really can be helpful. Sometimes, primary care physicians may not be familiar with medications for alcoholism, so seeking treatment from a psychiatrist may be necessary,” she explained. “At Blount Memorial, we have an excellent inpatient and intensive outpatient program that treats alcohol and other substance use disorders in a holistic manner. In the course of these programs, people can be evaluated for treatment with medication to assist them in maintaining sobriety and can be referred to our outpatient services following treatment. Alternatively, people involved in a program such as AA can contact our outpatient clinic for an intake appointment if they are interested in medication-assisted therapy to aid in abstinence,” she added.

Dr. Wood sees patients at Parkway Psychiatric Service, located at 451 Blount Memorial Physician Office Building in Maryville. For more information or to schedule an initial appointment, call Parkway Psychiatric Service at 865-980-5377.

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