Alcoholism coding: Disulfiram

The drug is used to code for alcohol dependence. In the modern treatment of alcoholism, disulfiram is a drug that prevents the use of alcoholic beverages. The desire of the patient to be cured, together with the unusual effects of the drug, make it possible to achieve success at any stage of alcohol dependence.

The specialists of the family mental health clinic offer their patients professional treatment for chronic alcoholism, help to get rid of a serious illness once and for all.

Disulfiram - description, composition, effect, properties

Disulfiram is a pill for alcohol addiction. Yellowish crystalline powder replenished the arsenal of anti-alcohol agents in the middle of the last century. Back in the 30s. 20th century the chemical began to be incorporated into the industrial rubber vulcanization process. American workers often came into contact with a chemical compound called tetraethylthiuram disulfide. They noticed a strange effect of disulfiram - only those who drank alcohol became seriously ill and could not go to work. The chemical had no effect on completely sober employees.

A few years later, the drug was decided to be used as an anthelmintic agent. And again, only selected participants in the experiment, who had recently consumed alcohol, fell ill. The research decided to continue and quickly realized that the combination of ethyl alcohol and the suspected poisoning culprit could be used medicinally.

Soon, the medical department recognized disulfiram as the official drug for the treatment of alcoholism in the United States. The research continued. Soon, chemists and pharmacists in many countries of the European and American continents were able to obtain exact analogues of disulfiram.

Disulfiram today is an officially used medical drug included in the register of medicines in most states. Analogs - "Teturam", "Esperal" and "Antabus".

An agent for curbing cravings for alcohol causes an unpleasant reaction of the body only in the presence of ethyl alcohol. Isolated administration of disulfiram does not lead to toxic effects and any tangible symptoms.

Disulfiram tablets are designed to develop an aversion to alcoholic beverages.

Basically, narcologists prescribe the drug in the form of:

- tablets;

- gel for subcutaneous injections;

- implant capsules;

- solution for subcutaneous and intramuscular injections.

The tablet form of the drug is effective against the background of its long-term and constant use. The therapeutic effect is reduced with the self-cancellation of the substance.

Gel in the form of injections into the skin in the lower abdomen is designed for up to 3 years. A single injection is active for 6 months.

Implants with disulfiram capsules affect the coded from 1 to 5 years. The duration of action depends on the dosage.

The effect of the drug on the human body

When ethyl alcohol is in the blood, enzymes neutralize it and turn it into acetaldehyde. which is toxic to the human body. The principle of action of disulfiram is based on the blockade of the enzyme acetaldehyde dehydrogenase, which converts dangerous aldehyde into acetic acid. It is excreted from the body naturally.

If disulfiram is present in the blood, then acetaldehyde cannot go into a safe form, its concentration in the blood increases rapidly and exceeds the permissible limit by 5-10 times. The natural reaction of the body to the action of disulfiram is pronounced symptoms of intoxication:

- nausea and vomiting;

- trembling all over the body;

- lowering blood pressure;

- Strong headache;

- weakness and sweating;

- blurred vision;

- confusion or complete loss of consciousness.

If this state is repeated several times, the brain develops a conditioned reflex - an aversion to alcohol. In the future, it occurs with its smell and appearance, even without ingestion.

To develop such a reflex after taking the pills, the doctor gives the patient a small amount of vodka or beer to drink. Soon a violent reaction to alcohol begins. All symptoms of poisoning are repeated.

Sometimes it happens that the relatives of the patient begin to treat him without any consent and knowledge. They simply sprinkle powdered disulfiram into food. Such actions are completely reckless and only harm the patient. Uncontrolled intake of the drug causes serious harm: disulfiram, together with ethyl alcohol, is toxic to internal organs and the nervous system. Alcohol is not neutralized and is not excreted from the body for a long time.

If you give disulfiram to a drunk person without his knowledge, a picture of severe poisoning develops. Therapeutic action should not be expected in such a situation:

The patient does not see the connection between the deterioration of the condition and the intake of alcohol.

The brain does not create conditioned reflexes to alcohol compounds.

Ethanol poisoning greatly worsens the condition of the liver and kidneys, and can lead to irreversible brain damage.

The main task of relatives is not to start treatment on their own, but to convince the patient to turn to professionals.

In a specialized mental health clinic, the problem of alcohol dependence is solved in a complex way. One of the directions of its correction is weaning from alcohol through aversion to alcohol-containing products.

How long does the drug stay in the body?

After taking a disulfiram tablet, it is rapidly absorbed into the bloodstream and undergoes a series of chemical transformations, it begins to act after about 2 hours. The maximum effect is observed 12 hours after administration.

Part of the drug is deposited unchanged in adipose tissue and stored in it as a kind of storage, from which it is gradually released into the open bloodstream. Disulfiram is excreted from the body for a long time, so the therapeutic effect lasts up to 2 weeks after discontinuation of the drug.

Patients are sometimes interested in when and how much to drink after taking disulfiram. Clinic specialists remind: even after 14 days it is found in the body, and therefore exhibits a toxic effect when interacting with any amount of ethyl alcohol.

If a conditioned reflex to aversion to alcohol has formed, the symptoms of intoxication are repeated already at the minimum dose.

The consequences of taking the drug

After taking the drug, disorders of the nervous system and sensory organs can occasionally occur:

- bitter taste in the mouth;

- headache and dizziness;

- memory impairment;

- sleep disorders;

- increased anxiety.

Side effects of disulfiram are infrequent, do not occur in all patients and disappear after dose adjustment by the doctor. Most often, such phenomena are expressed in a mild form and do not cause severe discomfort. It is necessary to cancel the drug only in case of severe reactions of individual intolerance.

Signs of drug intolerance are:

- itchy rashes on the skin;

- urticaria;

- angioedema;

- difficulty breathing and bronchospasm.

Combination of the drug with other substances

Treatment with disulfiram after binge begins no earlier than 5-7 days after the last alcohol intake. The timing of the start of treatment does not depend on the duration of the binge and the age of the patient.

Before starting therapy, the patient is tested for the presence of alcohol in the blood. If it is negative, the therapeutic course begins. The doctor monitors the patient's response to the drug, depending on its severity, increases or decreases the administered dose.

Treatment with disulfiram is contraindicated if alcohol is present in the patient's blood. In this case, detoxification is preliminarily carried out, because. the consequences of taking disulfiram and alcohol at the same time can be very serious and threaten life-threatening health disorders. The doctor warns about this at the first visit to the clinic.

If long-acting disulfiram is to be treated, the narcologist reports that a dose of vodka over 50 g against the background of an active capsule can lead to:

- severe respiratory disorders;

- cardiac arrhythmias;

- edema;

- convulsions.

The formation of aversion to alcohol is possible with the patient's persistent desire to get rid of addiction.

It is necessary to start therapy under the obligatory supervision of a mental health clinic specialist.

Only the professionalism of the medical center staff will relieve the pathological craving for alcohol and allow the course to be carried out safely for the patient.

During treatment with disulfiram, situations often arise when it is necessary to use it against the background of chronic diseases of the internal organs and the nervous system. The patient must inform the doctor about the constant use of other medicines. The narcologist evaluates the possible risks of using several drugs, including disulfiram.

Therefore, it is highly undesirable to self-medicate with disulfiram at home, where it is not possible to adequately assess the state of internal organs against the background of the therapy started, conduct laboratory monitoring of liver and kidney functions, and notice a change in blood biochemical parameters. It is possible to carry out safe therapy only in stationary conditions of a specialized clinic.

During treatment with disulfiram, situations often arise when it is necessary to use it against the background of chronic diseases of the internal organs and the nervous system. The patient must inform the doctor about the constant use of other medicines. Sometimes they have to be cancelled.

Simultaneously with disulfiram are not used:

1. Phenytoin. An anticonvulsant and antiarrhythmic drug is often prescribed for complications and consequences of alcoholism. Against the background of the combined use of two drugs, an overdose of phenytoin occurs with respiratory depression. The doctor reduces the frequency of taking the anticonvulsant or replaces it with another drug.

2. Isoniazid. The drug for the treatment of tuberculosis against the background of coding with disulfiram disrupts the psyche - the patient develops aggressive behavior, which is then replaced by depression. Disturbed by headaches and coordination disorders.

3. Metronidazole. An antimicrobial agent also causes mental disorders up to severe psychosis.

Many antidepressants enhance the effect of disulfiram, leading to pronounced toxic effects.

Treatment of alcohol dependence in a specialized clinic allows you to quickly respond to any emergency situation, timely adjust the dosage and regimen of medication.

The help of a specialist is needed at any stage of the treatment of alcoholism. The sooner the patient realizes the need for therapy, the more successful the efforts of health workers and relatives will be.

In modern narcology, highly effective medications are used, which, if the patient wishes, can save him from addiction.

It is strongly not recommended to resort to the services of imaginary healers who promise a quick recovery without significant effort. On the part of the patient, a conscious and persistent desire to overcome the disease is required.

The mental health clinic employs professionals with extensive experience in the treatment of alcoholism and its coding.

Diagnosis and treatment

The decision to start therapy with disulfiram is made by a narcologist. Before starting treatment with disulfiram, he prescribes a complete diagnostic examination of the body. It is necessary to eliminate the possible risks of using the drug. The patient is assigned:

- general clinical examinations of blood and urine;

- biochemical control of liver and kidney samples;

- radiography of the chest;

- cardiogram;

- Ultrasound of the heart and other internal organs;

- if necessary - CT and MRI.

If, according to the results of the studies, there are no contraindications for treatment with disulfiram, therapy begins to develop an aversion to ethanol.

Indications for treatment with disulfiram:

- treatment of alcohol dependence;

- prevention of its recurrence.

Disulfiram is included in various treatment regimens:

- traditional;

- accelerated with high doses of the drug;

- prolonged with subcutaneous implantation of capsules;

- preventive.

Treatment of alcoholism with disulfiram is carried out in stages:

The drug is prescribed in a saturating dose for a week. The tablet is taken in the morning during breakfast.

The first provocation test is performed under the supervision of a doctor. The patient is given to drink about 30 ml of an alcoholic beverage. For mild symptoms, add another 20 ml.

A repeated alcohol test is performed after 2 days in a hospital or after 3-5 days in a clinic. With a weak response, the dose of alcohol is increased by another 10-20 ml.

A maintenance dose of disulfiram is prescribed for a long time, for a period of up to 3 years after the main course. During treatment, it is forbidden to drive a car, because. the patient's concentration and memory are reduced.

The course of treatment with disulfiram is absolutely contraindicated in:

- diabetes mellitus and thyrotoxicosis;

- severe degree of hypertension;

- pulmonary tuberculosis;

- bronchial asthma;

- bleeding stomach ulcers;

- mental illness and epilepsy;

- inflammation of the auditory and optic nerve;

- glaucoma;

- oncopathology;

- pregnancy and breastfeeding.

Relative contraindications are:

- recovery period after a stroke;

- infectious diseases of the brain;

- exacerbation of peptic ulcer of the stomach and duodenum.

After the condition improves, treatment can also be carried out.

There are also non-standard treatment regimens with disulfiram. With high motivation, the patient is offered a 20-day course of disulfiram therapy at higher dosages. Alcohol testing is not carried out. After such abstinence from alcohol, the desire to drink decreases, an aversion to alcoholic beverages is formed.

Another method is popularly known as "filing". In the subscapular region, under local anesthesia, after several small skin incisions, up to 8 tablets of disulfiram are placed in them. The incisions are sutured, the wounds are treated and a sterile dressing is applied. For 2 days, the tablets dissolve and distribute in adipose tissue, and then the active substance gradually enters the general circulation.

The main advantage of this method is the complete absorption of the drug and its mild effect. To prevent side effects, the patient is recommended multivitamins and separately vitamin B1. Thus, it is possible to avoid neurological disorders, in particular, polyneuropathy with a violation of the sensitivity of the fingers and toes.