Alcohol addiction (alcohol dependence) is the most common addiction disorder. In Germany, a total of about 2 million people suffer from alcohol addiction severe enough to require treatment. That is about 5 percent of adult men and 2 percent of adult women. Every year, about 42,000 people in Germany die from the consequences of alcohol addiction (e.g., cirrhosis of the liver).
Learn more about alcohol dependence here and find selected doctors who specialize in treating alcohol addiction.
Any amount of alcohol consumption poses a health risk. Therefore, it would be advisable to avoid alcoholic beverages entirely. The risk of cirrhosis of the liver arises with regular daily alcohol consumption of more than 24 g for men and 12 g for women. That is about 0.5–0.6 liters of beer or 0.25–0.3 liters of wine for a man, and half that amount for women.
7.9 million people in Germany consume alcohol in a way that poses a health risk (Source: ESA 2021) @ Pormezz /AdobeStock
Alcohol Addiction: A Case Report
A 24-year-old unemployed patient presents himself at an addiction counseling center. He has been drinking heavily for the past 5 years. His consumption has increased over the past two years following his breakup with his girlfriend. At that time, he was drinking seven bottles of beer and half a bottle of schnapps daily.
The patient is no longer able to abstain from alcohol. If he does, withdrawal symptoms (restlessness, sleep disturbances, tremors, and mood swings) set in. He also quickly loses control once he starts drinking. He is then unable to stop until he is intoxicated.
Physically, he is in poor condition. His liver enzymes are elevated, and he feels weak and unable to function. He is motivated to end his alcohol addiction so that he can once again care for his 3-year-old son.
The family doctor refers the alcohol-dependent patient to a specialized clinic for psychiatry and psychotherapy. There, he must strictly abstain from alcohol. Over the next 3 weeks, the triggers and maintaining factors of his alcohol consumption will be identified.
Working with therapists and doctors, the patient builds the motivation to continue abstaining from alcohol. All of this is incorporated into the treatment plan.
One year after discharge, the patient remains sober. He attends regular follow-up appointments with his family doctor and the addiction counseling center. He also participates in meetings of the “Alcoholics Anonymous” self-help group.
Treatment for Alcohol Addiction
The goal of therapy is complete abstinence from alcohol.
Those affected can achieve this as follows:
- Detoxification followed by short-term treatment (duration: approx. 3 weeks with inpatient motivational therapy; success rate after 1 year approx. 30 to 40 percent)
- Detoxification followed by a 2- to 4-month withdrawal treatment (success rate after 1 year: approximately 50 to 60 percent).
The key to success is always the alcohol-dependent patient’s own motivation. They must be willing to abstain from alcohol and be open to receiving help.
About 50 percent of patients suffer from another mental disorder (e.g., an anxiety disorder). This is usually also the underlying cause of their alcohol addiction. Therefore, patients should treat the underlying condition following detoxification. This can help them avoid relapses into alcohol use.
Alcoholics Anonymous meetings usually take place once a week @ dikushin /AdobeStock
Treatment of Alcohol Withdrawal Syndrome
If alcohol-dependent patients stop drinking, they usually develop a physical alcohol withdrawal syndrome. This can happen intentionally or unintentionally, such as following an accident requiring hospitalization. Alcohol withdrawal syndrome typically lasts three to seven days.
The following symptoms appear during this time:
- Nausea, diarrhea
- Rapid heart rate, high blood pressure, shortness of breath
- Sweating, tremors, muscle twitching
- Insomnia and restlessness
- Depressed or irritable mood, anxiety and jumpiness, increased drive
- Difficulty concentrating and being easily distracted
- Seizures (grand mal seizures)
About one-third of patients require medication with Distraneurin® or other drugs. In severe cases, alcohol delirium (delirium tremens) may also develop, which requires intensive care. Therefore, stopping alcohol consumption should always be done in consultation with a doctor.
Preventing Alcohol Relapses
Taking the medication acamprosate (Campral®) after completing detoxification can help prevent alcohol relapse. Therapy with disulfiram (Antabus®) is a form of aversive therapy. The patient takes the medication daily.
If they drink alcohol while taking the medication, they can expect a disulfiram-alcohol reaction. This manifests as vomiting, anxiety, dizziness, etc. These unpleasant consequences are intended to prevent relapses.
Aftercare Following Withdrawal or Detoxification
Patients who receive ongoing medical and psychological care following withdrawal treatment or long-term rehabilitation have a better chance of staying alcohol-free in the long term.
Elements of aftercare include:
- Participation in self-help groups (Alcoholics Anonymous, Blue Cross, Good Templars, Kreuzbund)
- Regular follow-up visits with a primary care physician for physical symptoms
- Individual therapy with a psychiatrist or psychologist, especially if other mental health conditions are present
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