Alcohol
- Barbara Hoefener NP
- Aug 9
- 4 min read
Alcohol by Barbara Hoefener NP
*There are multiple resources in this article.
YES:
Alcohol use disorder (AUD) can be treated.
A person with a drinking problem can recover and regain a healthy life.
Most people with a drinking problem need help returning to a healthier lifestyle.
Stats:
12 years & older: per NSDUH 2023 study = 61.4 million people, 21.7% for "Past Month Binge Drinking"
26 years & older: 23 million adults in USA has a Diagnosis of AUD.
Deaths: Excessive alcohol use is responsible for 500 US deaths daily, 1 in 8 aged 20-64yr.
Less than 10% with AUD seek treatment.
Step 1- Recognize you have a problem and seek Help.
Average # recovery attempts 2-5 tries.
How much is too much? see chart
General Rule: > 3 drinks per day OR 7 per week.
Standard drink contains 0.6oz pure alcohol.
Example:
12 oz beer ~5% alcohol
8oz malt liquor ~12% alcohol
5oz wine ~15% alcohol
2-3oz of ~24% alcohol
1.5oz 80 proof shot/ ~40% alcohol.
Indicators of Potential Alcohol Use Disorder
Drink more, or longer than you intend
Try to cut down or stop drinking, but unable
Have cravings or strong urge to have a drink
Have to drink more than you once did to get the effect you want
Continue to drink even though it makes you feel depressed or anxious or adds to another health problem.
Spend a lot of time drinking, getting alcohol, or recovering form drinking
Find that drinking often interferes with daily activities, family, friends and/or work.
Cessation of or reduction in alcohol use that has heavy or long results with withdrawal symptoms. Ex: sweating, high pulse rate, hand tremor, insomnia, nausea or vomiting, hallucinations, agitation, anxiety or seizure.
Step 2 – Withdrawl & Detox
Typically lasting 1-4 days, sometimes 10 days.
This Must be done at a Alcohol Detox Facility. As they are specifically equipped for seizures and/or sweating, anxiety, depression, muscle aches and nausea. Withdrawal from alcohol can be fatal depending on how much you were drinking.
*step 3,4,5 are done together
Step 3 – See a medical provider weekly at first then monthly for accountability and support throughout recovery. Not even 1 drink, ever.
Review: Your goals
Withdrawal management – hospital, detox center, or at home
Meds to help with long term recovery
Review all meds currently taking
How to avoid situations that may cause you to start drinking again.
Remove all environmental influences.
Counseling plan and support groups update.
Step 4- See a mental health counselor weekly- for:
Individual – co-occurring mental health issues, bad work or home environment, PTSD, anxiety, depression, bipolar, etc.
Group counseling/ support groups- as you are not alone.
Required the first year for success.
Step 5 – Enroll in AA and participate!
Success rate – No drinking ever!
Problems related to Alcohol
Accidents & Trauma. Violence and suicide.
Cardiovascular – Hypertension, heart disease, vascular disease, stroke.
Cancer
Colo-rectal
Breast- female – 32% increased risk with even 1 drink a day. (hormones & folate)
Head & Neck: Oral / pharynx/ larynx/ esophagus – 40% mortality with <1 day drink
Liver
Pancreas
Lung
Osteoporosis
Pancreatitis
Cholelithiasis- Gallstones
Liver Disease / Dysfunction
Kidney / Renal Disease/ Dysfunction
Diabetes
Dementia
Medication for Alcohol
. Most medications are used to either aid in the detox/withdrawal process or to help patients remain sober by diminishing the strength of cravings. Some medications simply block the effects of opioids or alcohol, while others provide the patient a very eventful, unenjoyable experience if they consume alcohol.
***All 4 Medications have about a 15% efficacy. “Helps around edges.” *per MD who works in this filed daily, this stat is not found in research.
**I spoke w Serenity lane- and I highly suggest that program if you are in Eugene.
"SE"= side effect.
1. Naltrexone – The "Go-To Med" for withdrawal places including Serenity Lane. Easiest to stay on as only once a day, with the least complaints. First few days 25mg then 50mg daily. Comes as a monthly IM injection as well, needs a Prior auth with insurance.
Decreases or completely blocks the receptors that give the feeling of being drunk.
Decreases the number of relapses.
SE: N/V, injection site reaction, headache, dizzy, nervous, tired, decreased appetite, yellow skin/ eyes, coughing, suicidal thoughts*
SE: per MD who treats regularly with this medication: Mild “blah” or Dysphoria (unease, dissatisfaction, or discomfort, often accompanied by feelings of anxiety, restlessness, or depression).
2. Topiramate - Start 25/50mg daily then after a few weeks 100mg.
Decreases cravings for alcohol.
Repairs chemical imbalance in systems of the brain responsible for excitation and reward.
SE: Abnormal tingling, nervous, tired, poor coordination, sleepy, belly pain, reduced appetite, poor memory*, confusion*, movement slowing*, difficulty w concentration or finding words*, suicidal thoughts*
3. Acamprosate - 333mg 2 tabs 3xd. Start: ASAP after withdrawal when abstinence achieved; Info: continue treatment even if relapses happen.
*8/2025- having supply chain issues, getting to pharmacy. Compliance issues because dose is to be taken 3 tab 3 times a day. Helps w anxiety & sleep.
Repairs chemical imbalance in systems of the brain responsible for excitation.
Decreases the number of relapses.
*Used after the detox period of alcoholism
Relieving emotional stress and negative feelings.
SE: Diarrhea, nervous, weakness, difficulty staying asleep, Depression*, Suicidal thoughts*
3. Disulfiram/ Antabuse – Neg reinforcement.
Not to use if “fragile” (COPD/ Heart Failure)
Deterrent medication because if you drink while on this medication it causes stomach pain and vomiting.
Causes unpleasant effects when alcohol is consumed, such as
o Sweating/ Flushing of the face.
o Headache.
o Difficulty breathing.
o Nausea / Vomiting
Does NOT decrease alcohol cravings.
Avoid ALL alcohol, including in mouthwash or etoh in OTC meds
SE: sleepy, metallic taste, Headache, yellow skin/ eyes, tingling/ numb to hands/ feet*, confusion*, losing contact with reality*, excessive reaction with alcohol*
Resources:
Military Health System – information about addiction, substances, treatments and getting help health.mil
TRICARE Alcohol Awareness – information and support resources on excessive drinking in the military tricare.mil/HealthWellness/Alcohol
U.S. Department of Veterans Affairs – For help making medical appointments and with prescription refills myhealth.va.gov
Military OneSource – online, telephone, and face-to-face non-medical counseling militaryonesource.mil | (800) 342-9647
Psychological Health Resource Center – a 24/7 anonymous information call center www.health.mil/PHRC | (866) 966-1020
Veterans Crisis Line – a 24/7 anonymous crisis hot line http://www.veteranscrisisline.net | (800) 273-8255 and press “1”
NHS
https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-use-united-states-age-groups-and-demographic-characteristics
Serenity Lane conversation with MD.
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