alcohol treatment

  Alcoholism: treatment with GHB (sodium gamma-hydroxy-butyrate)
matteopacini

    The article illustrates the method of treatment of alcoholism with GHB, framing it in the context of the available therapies.

The treatment of alcoholism (see articles on the subject in this same site) can count on a series of pharmacological tools. Some of these tools have been directly designed to interfere with the behavior of alcohol consumption by the "pathological" drinker, while others have been designed as tools to directly control the desire to drink.

The difference lies in the fact that the first type of therapy (naltrexone, disulfiram) works because the effect of drinking is made unpleasant, or is held back, so that the first drink does not follow the actual relapse. The second group of therapies, on the other hand, affects the brain mechanisms of alcoholism even before reaching the relationship with alcohol, that is, conditioning the desire to drink at the start.

Despite this variety of tools, treating an alcoholic subject is not easy, and the percentage response, meaning only the so-called "complete" answers (natural control over the desire to drink with stable abstention) is not high for the individual instruments. Furthermore, the results are confused by the fact that by its nature the alcoholic patient tends not to be constant and focused on the regularity of the assumption of a cure, so that many relapses occur after the suspension of treatment, or are facilitated by the fact that the patient suspends cure during a weakened relapse.

Sodium gammahydroxybated (GHB) is a long-standing product, but its use is often limited in time and not organized in order to obtain the best results.

Treatment-resistant alcoholics.

60% of these subjects reduced alcohol intake, some significantly, some by totally suspending it. The value of these results does not concern the achievement of an objective after detoxification, that is, how many return to drink after interrupting, but the result achieved starting from the initial conditions of chronic intoxication, during a year of treatment with GHB.

GHB requires the involvement of operators who live with the patient or family members, who are entrusted with the custody and delivery of the drug, in order to check its correct use. The correct use consists in taking a certain dose a day (syrup), constant, fractionated in 4 or better 6 times at regular intervals as much as possible. What instead easily happens if the patient has no supervision is that he skips a few doses, that takes more than one set, and in a part of the cases that he starts using GHB not as a medicine but as an intoxicating substance.

When the patient begins GHB can also stop drinking, since GHB has activity against abstinence, but in this case the situation and the doses should be decided by the doctor according to the conditions of the first days, and never in self-management. If the patient does not stop drinking, the therapy can be done equally, and in this case its effects will be directly visible in real time, as it will be immediately possible to adjust the dose in case of unsatisfactory answer. In case the patient "starts" with the abrupt suspension of alcohol, the usefulness of the cure in preventing relapses will have to be established over the months, and the dosages adjusted if and when such relapses occur.

Treatment with GHB, being a treatment that directly influences the hinge of alcoholism, ie the impulse to drink and the desire that precedes it and accompanies it, has some peculiarities. In other treatments (such as the one with disulfiram) there are only two possibilities: either the abstention or the failure of the treatment (due to its interruption or to significant health risks because the person can not drink despite serious toxic reactions with disulfiram). In other treatments, similarly, either the answer is complete, or is not significant. In this case, however, it is proven that even alcoholics who do not stop drinking (but reduce substantially) benefit in terms of recovery of their mental functions and their social adaptation, up to levels equivalent to those that completely suspend.


 The relapse, as in any other treatment for alcoholism, is not the end of the attempt, but the beginning. Each treatment for an addiction passes through initial relapses, which must be managed by adjusting the treatment. The change that is obtained at the beginning (first weeks) tends to be either scarce or drastic: some stop drinking and some do not succeed.
Usually the former are considered "on the right track", and the latter appear to start on the wrong foot. Instead, the most reliable answer should be measured later, after the first few months. The treatment should be continued and strengthened through relapses, with total control as the ideal aim, but considering incomplete progress in the meantime acceptable.

Treatment with GHB is a long-term treatment, but this is not a new element. All treatments for alcoholism are designed to last a long time. As well as for other treatments, psychotherapy and psychoeducation of alcoholics can go hand in hand with pharmacological care. The same understanding of the importance of a treatment regimen, of its regularity, of the purpose and of the mechanisms by which a cure restores control to the person are topics that improve the awareness of illness and help the patient and family to identify the "pathological drinking" (behavior) and not alcohol (the substance) as the main goal of treatment.

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