How to treat alcohol and drug addiction?

According to world health organisation (WHO) a drug is defined as any substance that, when taken into the living organism may modify one or more of its functions. When any drug or alcohol takes on a much higher priority in an individual and alters the person's physiological, behavioural and cognitive pattern then it is referred to as addiction. Common substances that are classified as psychoactive substances are alcohol, opioids, cannabinoids, cocaine, amphetamines, hallucinogens, sedatives, hypnotics, inhalants, nicotine, and other stimulants (e.g. caffine).

Alcohol treatment:

Alcohol treatment can be broadly divided into two types and they are often interlinked with each other. The basics of alcohol treatment is detoxification and alcohol treatment dependence.

Detoxification is the first major step in alcohol treatment. Treatment of alcohol withdrawal symptoms is called as detoxification. The best way to do detoxification in alcohol treatment is to stop alcohol suddenly. The drug of choice in alcohol treatment of detoxification is benzodiazepines. Chlordiazepoxide and diazepam are the most frequently used benzodiazepines. The drugs used are decreased steadily everyday before being stopped. Vitamins (thiamin and nicotinic acid) should be supplemented during this course of alcohol treatment. Hydration is the next important aspect that should be taken care.

Alcohol treatment for dependence can be achieved by several methods like
1. Alcohol treatment for dependence by behavior therapy: The most commonly used behavior therapy is aversion therapy and it can be used in combination with other methods like relaxation techniques, assertiveness training, self control skills and positive reinforcements.

2. Alcohol treatment for dependence by psychotherapy: The person is educated about the risks of continuing alcohol use and the importance of resuming personal responsibilities. This can be achieved by supportive and individual psychotherapy.

3. Alcohol treatment for dependence by group therapy: Group therapies are usually done by voluntary self help groups and the approach is partly religious in nature. Many are benefited through this because they are non- professional in nature.

4. Alcohol treatment for dependence by deterrent agents: The deterrent agents are called alcohol sensitizing drugs. Disulfiram is the commonly used effective drug. It produces unpleasant reaction when taken with alcohol. The disulfiram-ethanol reaction is life threatening and is characterized by flushing, tachycardia, hypotension, tachypnea, palpitation, headache, sweating, shock, convulsions, myocardial infarction, confusion and coma.

5. Alcohol treatment for dependence by other medications: Some of the other drugs used for alcohol treatment are benzodiazepines, antidepressents, antipsychotics, lithium, carbamazepine, and narcotics. These drugs are used only if there is special indication.

Drug treatment:

1. Opioid addiction: Morphine and heroin are the common drugs that causes drug dependence. Other opioids are codeine, thebaine, papaverine, nalorphine, hydromorphone, methadone, pethidine, and levallorphan. They are mainly administered intravenously for potency but they can be smoked or chased.

Drug treatment of opioid disorders: Drug treatment starts with proper diagnosis made by history, physical examination (pin point pupils), and laboratory tests. Detoxification of opioids is done abruptly and is followed by management of withdrawal symptoms. Drugs used to manage withdrawal symptoms are methadone, clonidine, naltrexone with clonidine, and other agents like levo-alpha-acetyl-methadol, buprenorphine, and lofexidine.

After detoxification phase the drug treatment for opioid addiction is continued by maintenance therapy using methadone and opioid antagonists. Individual psychotherapy, behaviour therapy, family therapy, group therapy, and psychotropic drugs are also included depending upon the persons needs. As relapse rates are high psychosocial rehabilitation is highly advised in both occupational and social levels.

2. Cannabis addiction: Cannabis produces very mild physical dependence and withdrawal syndrome. All active ingredients are called as marijuana or marihuana.

Drug treatment of cannabis disorder: As the withdrawal symptom is very mild, the management is usually supportive and symptomatic treatment. Psychotherapy and family therapy are important if there is psychic dependence.

3. Cocaine addiction: Cocaine can be administered orally, intranasally, or parentrally. They are sometimes used in combination with heroin or amphetamines.

Drug treatment of cocaine disorder: Drug treatment is seperate for cocaine overdose and cocaine chronic use. In cocaine overdose, the treatment consists of oxygenation, muscle relaxants, and IV thiopentone. In cocaine chronic use, bromocriptine and amantadine is used to reduce cocaine cravings.

4. Amphetamine addiction: Amphetamines are used medically for certain conditions to heighten energy and produce more capacity to work but continuous use leads to addiction.

Drug treatment of amphetamine disorder: Amphetamines intoxication is treated symptomatically with antipyretics, diazepam, halloperidol and antihypertensives. Acidification of urine with oral NH4CL 500mg facilitates the elimination of amphetamines. Antidepressants and supportive psychotherapy are helpful in treating amphetamine dependence.

5. LSD addiction: Lysergic acid diethhylamide is a powerful hallucinogen. Although tolerance and psychological dependence occurs with LSD use, no physical dependence or withdrawal syndrome is reported.

Drug treatment of LSD disorder: The drug treatment consists of symptomatic management with anti-anxiety, antidepressants along with supportive psychotherapy.

6. Barbiturate addiction: Barbiturates are sedative, hypnotic and anxiolytic agents that causes marked physical and psychological dependence.

Drug treatment of barbiturate disorder: Pentobarbital substitution therapy is suggested for the treatment of withdrawal syndrome. Supportive treatment should be followed after detoxification phase.

7. Benzodiazepines and other sedative-hypnotic addiction: Benzodiazepines and sedative-hypnotic are prescription drugs that are used to treat many conditions.

Drug treatment of Benzodiazepines or sedative-hypnotic disorders: The treatment is usually symptomatic. Flumazenil is a benzodiazepine receptor antagonist that is commonly used in detoxificaion followed by supportive treatment.

8. Inhalants addiction: Petrol, glues, aerosols, thinners, varnish removers are commonly used as inhalants.

Drug treatment of inhalant disorders: There is no specific treatment for this disorder and is usually associated with schizophrenia.

Though the above mentioned treatments are available for drug and alcohol addiction, the key factor is the addict's whole-hearted desire to recover from the addiction and will power to resist any cravings to drug and alcohol.

Simple ways to reduce anxiety

Anxiety is a normal reaction towards an upcoming stressful situation. It is our body's coping mechanism to prepare for the future. When there is too much of anxiety even for small things, we call it as anxiety disorder. It affects both the body and mind and thereby affects normal life. It can occur due to various reasons like an upcoming examination, a surgical procedure, a competitive sport, a deadline at office, an interview etc .

The symptoms of anxiety are headache, nausea, palpitation, chest pain, stomach discomfort, shortness of breath, tiredness, sleeplessness, irritability, restlessness, poor concentration, blank mind, bad thoughts and dreams like death. The signs of anxiety are high blood pressure, increased heart rate due to increased tension, tremors, paleness, sweating, panic attack, nail biting, foot tapping etc . . .

There are medicines like benzodiazepines, antidepressants and medical therapies like cognitive-behavioral therapy that could help in controlling anxiety.

Below are 10 simple and easy ways to decrease anxiety.

1. Positive thoughts

Positive thinking is the best way to decrease anxiety. Everybody has stress in life and is anxious at some point. This realization itself will bring about a positive thought. Compare yourself with others who are more stressed and see how they manage stress and try to learn from them. Always think that everything will pass away at its time and everything both good and bad is a part of life and learn to accept it. Nothing is permanent on earth. There is no one who does not get tested or get sick or lost something in life. So be assured that you are not alone. Practice every day to think positively.

2. Regular exercise

Exercise plays an important role in decreasing anxiety. Exercising produces a variety of chemicals and neurotransmitters in our body like endorphins, neurotrophins, corticosteroids and serotonin which calm down and sooth our disturbed mind. It also keeps you occupied and thereby decreases anxiety. The exercises need not be vigorous but make it regular by setting aside a time for it. Exercising keeps you fit and also gives a sense of wellness and gives a feeling of being in perfect condition which helps to enhance your self-esteem. It is also a great time to relax your mind.

3. Create a hobby

Having a hobby is a healthy habit where one can keep oneself occupied and forget their worries. It is a great way of distraction. It can be simple like reading books, painting, and gardening. Listening to slow and pleasant music is also a way to sooth your mind. Drawing or writing is a great way to express your feelings which releases your anxiety.

4. Eat a healthy balanced diet

Food can change your mood. Eating a healthy balanced diet keeps you healthy both bodily and mentally. We all need energy, proteins, fats, minerals and vitamins to function normally. Any imbalance will affect the function of brain. No medicines or therapies or exercises or hobbies can compensate your nutritional requirement of the body for its optimal functioning. Take time to cook and enjoy eating your food. Make sure your food has adequate vitamin B12 and omega 3 fatty acids which are good for brain health and have happy balanced moods. Herbs like Kava Kava, Licorice Root, Lavender, Passion flower and St. John’s Wort help in relaxation, reducing irritability and promoting sleep thereby controlling anxiety.

When we chose the food to eat, we should make sure the foods we eat will not increase anxiety. Alcohol and caffeine are foods which increase anxiety levels because they decrease the magnesium levels of the body which in turn reduces the production of serotonin which is one main neurotransmitter that helps in reducing anxiety.

5. Be in the company of others

Be with your friends when you feel down or anxious because they keep you occupied. If you have close friends whom you can rely on, you can open up your heart and ventilate your worries and anxieties. They can really comfort you and cheer you up with comforting words and even give ideas to come over the situation which are making you feel anxious. Your parents, spouse, grown up children or even your psychologist can counsel you and help you in overcoming your anxiety.

6. Meditation and Yoga

A quiet time is very important at least two times a day usually as soon as you get up or before you go to bed. Take this time to thank God for everything he has allowed in your life and ask for endurance to accept reality in life. Also utilize this time to appreciate the good things in you and tell it to yourself that you are worth of doing a lot of productive work and be a blessing to others.

Yoga is another way to keep your mind busy and concentrate more on body moves. These yoga moves release the tension in your body and brain and gives a great start to a day.

7. Deep breathing exercise

This is an instant way to relax and decrease anxiety that is welling up in your mind. Moreover it is easier than anything else. Just take deep breath and hold it for 3 to 5 seconds and exhale very slowly through your pursed mouth.

8. Rest and sleep

Your body needs rest and sleep for normal functioning of the brain. When you go to bed just relax and rest, shut down your brain and do not think of your upcoming events. Learn to be assertive in certain situations and avoid getting angry or aggressive. If you are assertive you will not mind what is to come and have a peaceful sleep.

9. Avoidance

There are certain worries which cause anxiety but can be avoided in life. If you can avoid something which can be stressful, it is better to do so rather than being stressed. Say no to smoking, alcohols, drugs or even taking over-the-counter medication which you know is not good for you.

10. Set time to worry

Though you do all the above, it is not easy to forget your worries and you cannot escape reality. Set aside a time to think about the worries and in that time make plans to overcome the situation and what to do if something bad happens like not getting through an examination, may be a divorce, losing a job, undergoing a major surgery or losing a beloved one and soon you will find there is an answer for everything and sometimes the post situations will be better and make you less anxious than what you are undergoing now.

If nothing works, seek medical support instead of being anxious. Psychotherapy and few medical tips can help to decrease anxiety. Spending time with those you love, being well organized and good time management can also go a long way in reducing anxiety.