HOMEOPATHY FOR ALCOHOL USE DISORDERS

Alcohol use disorder is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism.

Alcohol dependence is more common in males, and has an onset in late second or early third decade. The course is usually insidious. There is often an associated abuse or dependence of other drugs. If the onset occurs late in life, especially after 40 years of age, an underlying should be looked for.

Clinical types

According to Jellinek, there are five ‘species’ of alcohol dependence ( alcoholism) on the basis of the patterns of use, and not on the basis of severity.

A. Alpha

·         Excessive and appropriate drinking to relieve physical and/or emotional pain.

·         No loss of control.

·         Ability to abstain present.

B. Beta

·         Excessive and appropriate drinking.

·         Physical complications, e.g. cirrhosis, gastritis and neuritis, due to cultural drinking patterns and poor nutrition.

·         No dependence.

C. Gamma; also called as malignant alcoholism.

·         Progressive course.

·         Physical dependence with tolerance and withdrawal symptoms.

·         Psychological dependence, with inability to control drinking.

D. Delta

·         Inability to abstain.

·         Tolerance.

·         Withdrawal symptoms.

·         The amount of alcohol consumed can be controlled.

·         Social disruption is minimal.

E. Epsilon

·         Dipsomania (compulsive-drinking)

·         Spree- drinking.

Cloninger has classified alcoholism into two types. Type-1, and Type-11. This is on the basis of genetic and environmental factors.

Causes

Biological factors.

·         Alcoholism runs in families. Children of alcoholics become alcoholic about 4 times more than those of non-alcoholics while over 40% had a parent-usually the father-who is alcoholic.

·         Co-morbid psychiatric disorder or personality disorder.

·         Co-morbid medical disorders.

·         Withdrawal effects and craving.

Biochemical factors.

·         A genetically determined deficiency of brain neurotransmitters (endorphins) predisposes an individual to alcoholism.

Psychological factors:

·         Curiosity; need for novelty seeking.

·         General rebelliousness and social non-conformity.

·         Early imitation of alcohol and tobacco.

·         Poor impulse control.

·         Sensation-seeking (high).

·         Low self-esteem (anomie).

·         Concerns regarding personal autonomy.

·         Poor stress management skills.

·         Childhood trauma or loss.

·         Relief from fatigue and/or boredom.

·         Escape from reality.

·         Lack of interest in conventional goals.

·         Psychological distress.

Social factors:

·         Peer pressure, often more important than parental factors.

·         Modeling, imitating behavior of important others.

·         Ease of availability.

·         Strictness of law enforcement.

·         Intrafamilial conflicts.

·         Religious reasons.

·         Poor social/familial support.

·         ‘Perceived distance’ within the family.

·         Permissive social attitudes.

·         Rapid urbanization.

Symptoms

The DSM-5 lists of 11 symptoms that can be used to determine if someone has an alcohol use disorder.

·         Alcohol is often taken in larger amounts or over a longer period than was intended.

·         There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

·         A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

·         Craving, or a strong desire or urge to use alcohol.

·         Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.

·         Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

·         Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

·         Recurrent alcohol use in situations in which it is physically hazardous.

·         Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.

·         Tolerance, as defined by either of the following: a. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or b. A markedly diminished effect with continued use of the same amount of alcohol.

·         Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for alcohol, b. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Alcohol use disorder can include periods of alcohol intoxication and symptoms of withdrawal.

Alcohol intoxication :  After a brief period of excitation, there is generalized central nervous system depression with alcohol use. With increasing intoxication, there is increased reaction time, slowed thinking, distractibility, and poor motor control. Later dysarthria, ataxia and incoordination can occur. There is progressive loss of self-control with frank disinhibited behavior.

The duration of intoxication depends on the amount  and rapidity of ingestion of alcohol. Usually the signs of intoxication are obvious with blood levels of 150-200 mg%. With blood levels of 300-450 mg%, increasing drowsiness followed by coma and respiratory depression develop. Death occurs with blood levels between 400-800 mg%.

Sometimes a small dose of alcohol may produce acute intoxication in some persons. This is known as pathological intoxication. Another feature, sometimes seen in acute intoxication, is the development of amnesia or blackouts.

Withdrawal syndrome:   The most common withdrawal syndrome is handover on the next morning. Mild tremors, nausea, vomiting, weakness, irritability, insomnia, and anxiety are the other common withdrawal symptoms. Sometimes the withdrawal syndrome may be more severe, characterized by one of the following three disturbances: delirium tremens, alcoholic seizers and alcoholic hallucinations.

A. Delirium tremens

Delirium tremens is the most severe alcohol withdrawal syndrome. It occurs usually within 2-4 days of complete or significant abstinence from heavy alcohol drinking in about 5% of patients, as compared to acute tremulousness which occurs in about 34% of patients.

The course is short, with recovery occurring within 3-7 days. This is an acute organic brain syndrome (delirium) with characteristic features of:

·         Clouding of consciousness with disorientation in time and place.

·         Poor attention span and distractibility.

·         Visual (and also auditory) hallucinations and illusions, which are often vivid and very frightening. Tactile hallucinations of insects crawling over the body may occur.

·         Marked autonomic disturbance with tachycardia, fever, hypertension, sweating and pupillary dilatation.

·         Psychomotor agitation and ataxia.

·         Insomnia, with a reversal of sleep-wake pattern.

·         Dehydration with electrolyte imbalance.

Death can occur in 5-10% of patients with delirium tremens and is often due to cardiovascular collapse, infection, hyperthermia or self-inflicted injury. At times, intercurrent medical illness, such as pneumonia, fractures, liver diseases or pulmonary tuberculosis may complicate the clinical picture.

B. Alcoholic seizures

Generalized tonic clonic seizures occur in about 10% of alcohol dependence patients, usually 12-48 hours after a heavy bout of drinking. Often these patients have been drinking in large amounts on a regular basis for many years.

Multiple seizures (2-6 at one time) are common than single seizures. Sometimes, status epilepticus may be precipitated. In about 30% of the cases, delirium tremens follows.

C. Alcoholic hallucinations

Alcoholic hallucinations is characterized by the presence of hallucinations, usually auditory, during partial or complete abstinence, following regular alcohol intake. It occurs in about 2% of patients.

These hallucinations persist after the withdrawal syndrome is over, and classically occur in clear consciousness. Usually recovery occurs within one month and the duration is very rarely more than six months.  

HOMOEOPATHIC REMEDIES

Homoeopathy today is a rapidly growing system and is being practiced all over the world. It strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance  at mental, emotional, spiritual and physical levels. When ALCOHOL USE DISORDER   is concerned there are many effective medicines available in Homoeopathy , but the selection depends upon the individuality of the patient , considering mental and physical symptoms

ANGELICA : Angelica produces disgust for liquor It will also correct atony of different organs , dyspepsia, nervous headache etc.

APOCYNUM CANNABINUM:  Effective for curing great craving for alcohol. The patients are low spirited and experiences anxiety and depression. There is severe nausea and vomiting. The patient experiences difficulty in passing urine and it takes long time. The urine is hot , turbid mixed with thick mucus and burning in urethra after urinating.

ARSENIC ALBUM : Arsenic alb stops the craving for alcohol and helps in reducing the ill effects of excessive alcoholism. Arsenic patient  experiences great anxiety, restlessness and fear of death. There is delirium tremens.

CAMPHOR : Camphor should be tried when Angelica failed in controlling alcoholism. There is coldness in stomach followed by burning.

CAPSICUM ANNUM : Capsicum annum is  effective for controlling great desire for alcohol. It is prescribed when the patient has vomiting and diarrhea.

CHINA  OFFICINALIS: China will remove the craving for alcohol in drunkards who wish to reform.There is internal coldness of stomach and abdomen. Liver and spleen enlarged. Patient experiences flatulence , and there is belching of bitter fluid or regurgitation of food gives no relief.

QUERCUS GLANDIUM SPIRITUS: Quercus is considered to be a specific for alcoholism. There is dropsy and liver affections. It will antidotes the bad effects of alcohol.

STERCULIA : An effective remedy for alcoholism. It promotes the appetite and digestion and lessens the craving for alcohol.

STRYCHNINUM NITRICUM : Strychninum nitricum removes the craving for alcohol in any form.

SULPHURIC ACID : - Sulphuric acid is one of the top remedies for alcoholism. The patient experiences heartburn ,   sour eructation’s and sour vomiting. Craving for alcohol is an important  symptom of this remedy. It is prescribed when water causes coldness of stomach , must be mixed with liquors .The patient experiences relaxed feeling in stomach, which is relieved by heat application. Aversion to the smell of coffee .

SULPHUR : Sulphur should be tried when China fails . The patient has great desire to drink alcohol  all the time . Wants to drink from morning till evening or till awake. There is complete loss of appetite and very weak and faint feeling in stomach at about 11 am , must have something to eat.

HOMOEOPATHIC REMEDIES FOR THE BAD EFFECTS OF ALCOHOLISM

ANTIMONIUM TARTARICUM: Antimonium tart. is prescribed for vomiting in drunkards  with white coated tongue.

AVENA SATIVA: Avena sativa is prescribed for sleeplessness and nervousness in drunkards. Avena sativa takes away the longing for alcohol.

CARBONEUM SULPH: Carboneum sulph is very useful for people broken down by abuse of alcohol. Impotency, colour blindness  etc are cured by this remedy.

CARDUS MARIANUS: Cardus mar. is very effective for liver troubles, liver pain, constipation alternating with diarrhea  seen in chronics alcoholics especially beer drinkers.

COFFEA CRUDA: Coffea cruda is effective for headache due to alcoholism. Headache as if nails were driven in to the head. Worse in open air. It is also effective for sleeplessness, convulsions, and liveliness due to alcohol.

CROTALUS HORRIDUS : Crotalus hor. Is prescribed for liver diseases seen in chronic alcoholics .

CHIMAPHILA UMBELLATA 30- Chimaphila umbellate is effective for  the removal of renal and hepatic disorders in chronic alcoholics .

GELSEMIUM SEMPERVIRENS: Gelsemium is prescribed when nervous symptoms are predominant in alcoholics. There is excessive trembling and weakness of all limbs. The patient experiences lack of muscular coordination.

LACHESIS: Lachesis patients are ill- natured , inclined to violent crimes , vindictive, jealous, envious, incline to kill others and not himself. Talkativeness before and during drunkenness.

NUX VOMICA: Nux vomica is prescribed when there is giddiness and  restlessness after alcohol drinking. Heavy vomiting after drinking. The patient experiences nausea and trembling after drinking. Nervousness due to drinking wine or liquor. Nux vomica patients are frightened by little noise and spring up at night with dreadful dreams. This patients have a tendency to envy and jealousy. They commit  suicide by shooting or stabbing.

OPIUM: Delirium tremours over and over again. Expression of fright or terror on face. Breathing strenuous, visions of animals and ghosts with uneasy sleep. Face dark red.

PETROLEUM: Petroleum is effective when the drunkards are seen without energy, without strength of will , unable to refuse a glass of wine. Vomiting after the least excess in drinks. The patient talking too much when drunk.

RANUNCULUS BULBOSUS: Ranunculus bulbosus is effective for mental attacks of drunkards. It cures coma due to heavy drinking of alcohol and other bad effects of alcohol.

SECALE CORNUTUM: Secale cor is prescribed for insomnia due to the intake of alcohol.