The Medical Treatment of Alcoholism

by Mark L. Willenbring, M.D.

FIVE QUESTIONS TO ASK YOUR DOCTOR

1. First, do some homework.
If you have access to the Internet, check out Frequently Asked Questions and other research-based materials at www.niaaa.nih.gov. For a brief test for drinking problems, see also www.alcoholscreening.org. Or look in your local bookstore or library for books on alcoholism. It also helps if you know something about what kinds of treatments are available and what kind you might want (counseling, medications, etc.). Take this information with you when you see your doctor.
2. Let your doctor know you are concerned about your drinking, and why.
Ask whether she or he thinks you have alcoholism. If you drink a lot nearly every day, be sure to say so, because you may need treatment for withdrawal (sweating, tremor, anxiety, insomnia); quitting suddenly without treatment for withdrawal can be dangerous. Don't be afraid to ask for such treatment.
3. Ask your doctor if she or he prescribes medications for alcohol dependence, such as naltrexone (tablets or monthly injections) or acamprosate.
These medications act to correct abnormalities in the brain caused by alcoholism and make it easier to quit. They are not addictive, nor do they make you sick when you drink. Download and print a copy of the National Institute on Alcohol Abuse and Alcoholism publication Helping Patients Who Drink Too Much: A Clinician's Guide, and give it to your doctor available at www.niaaa.nih.gov/guide. It has information about diagnosis and treatment of alcohol dependence, including medications. If you would like to try one of them, tell your doctor.
4. Find out whether you have any evidence of organ damage, such as liver disease, due to heavy drinking.
Ask your doctor to order appropriate tests to find out. If you have organ damage, ask whether it will get better if you quit drinking, and what might happen if you do not.
5. Be sure to mention if you are feeling depressed, suicidal or anxious.
If you are experiencing one or more of these feelings, ask your doctor whether additional treatment would be helpful. One example might be an antidepressant medication. Many people with alcohol dependence also have depression or anxiety.