Nowadays, few people recognize themselves as ill with alcoholism. After all, alcoholics are those who drank work, real estate and family and while away their nights in free shelters. This is a common mistake: in fact, alcoholism begins already when a decent and wealthy-looking person "goes through too much." The modern pharmaceutical industry has invented many drugs against alcoholism, and one of the most effective is Esperal. Instructions for use, reviews and analogues - you will learn about this from this article.
Stages of alcoholism
Narcology distinguishes three stages of the development of chronic alcoholism. The sooner you start treatment with Esperal, the more effective it will be, and the healthier the patient will remain.
- The first stage usually takes from one to ten years for men and from one to four years for women. These values are averaged, sometimes alcoholism progresses faster or slower depending on the individual characteristics of the patient's body. At the first stage, there is still no binge, but the patient always abuses alcohol. It can be wine, cocktails, beer (more often women prefer) or cognac, vodka, chacha, tequila (strong drinks are more often preferred by men). It is absolutely not important what exactly to drink - the patient is always not enough, and the result is logical - a hangover in the morning. For the first stage, which will soon pass into the second, the development of withdrawal symptoms is characteristic.
- At the second stage, the patient gains tolerance to ethanol-containing drinks: he is no longer concerned about the gag reflex, the severity of the hangover syndrome is reduced. Instructions for use with Esperali and reviews report that at this stage the treatment can still be very effective, despite the fact that ethanol has already begun to integrate into the patient’s metabolism. Memory lapses begin (so-called palimsests): the patient does something, quarrels with loved ones, loses things, provokes fights, gets intoxicated, and in the morning either does not remember any of these events, or the memories are fragmentary. Binges begin, first lasting two to three days, and then can reach a week.
- At the third stage of alcoholism, treatment with Espreal, like any other means, practically does not bear fruit. The patient can no longer be stopped by anything - neither the fear of death, nor the suggestion of psychotherapists. Ethanol is integrated into the metabolism, and now a sick person needs it, like air to a living being. Irreversible damage to internal organs begins. Depending on the initial state of health of the patient, this process can take from a year to five, but the result will always be the same - this is death. If the alcoholic has survived to the third stage, he is most likely to be cirrhosis, ascites, pancreatic necrosis.
Esperal. Composition and form of release
The drug registry of the Russian Federation contains only one form of drug release - tablets. If narcologists, pharmacists or psychiatrists offer to buy the drug in the form of drops, gel or ampoules for injection, it is worth remembering that this is either a home-made product, or brought from abroad and not certified.
Instructions for use with "Esperal" reports that the main active ingredient of the drug is disulfiram. One tablet contains 500 mg of this substance. It is thanks to disulfiram that the drug is able to effectively resist alcoholism.
How does Esperal treat alcoholism?
Instructions for use with "Esperal" reports that the drug is effective for the treatment of chronic alcoholism when all other methods (psychotherapy, group AA sessions, occupational therapy) were ineffective. Treatment can take place both independently, at home, and in a hospital. Under the supervision of an experienced narcologist, you can carry out the Esperal torpedoing (this procedure will be described below).
The instructions for use with Esperal drops (tablets, ampoules, gel and all other forms of release have a similar principle of action) reports that the treatment of alcoholism with this drug is based on the fear of death. The drug does not remove cravings, does not discourage the desire to drink. A sick person will still be eager to “dive” from all his problems into a glass. He will not let him do this in the blood disulfiram.
If the patient’s body contains metabolites of disulfiram, and at this moment at least 5-15 mg of ethanol enters the bloodstream, then the so-called disulfiram reaction develops. This is the very process that has saved the lives of hundreds of thousands of alcoholics around the world. Alas, some patients paid for their disbelief in medicine and the treatment turned out to be fatal for them.
Disulfiram reaction manifests itself in the following symptoms:
- redness of the skin;
- a sharp increase in pressure;
- the possibility of a heart attack, stroke (in proportion to the amount of alcohol consumed) increases;
- loss of consciousness;
- indomitable vomiting (may lead to asphyxiation);
- intoxication and damage to internal organs.
Indications for use
The instruction for Esperal states that the main indication for use is the therapy of chronic alcoholism in the first and second stages. If there is a desire of the patient, then you can try to start treatment in the third stage. But it is too likely that the patient will drink on disulfiram, and such treatment will provoke disability or death.
Narcologists often prescribe Esperal (instructions for use with the gel and all other forms of release confirm this) for the prevention of breakdowns and the prevention of alcoholic beverages in patients at an early stage of alcoholism. There is an opinion that at the dawn of the disease, the patient may well cope with the desire to drink himself, "strong-willed effort." This is a dangerous misconception: alcoholism is a disease, and the willful efforts and decisions of a sick person do not solve anything.
Contraindications to the use of the drug
The instruction to Esperal reports that the drug is quite toxic to the body of an alcoholic, already exhausted by the constant abuse of ethanol-containing drinks. Therefore, resorting to the tool is only with the full confidence of the patient that he really wants to achieve remission.
Absolute contraindications for taking the drug "Esperal" (instructions confirm this) are:
- cirrhosis of the liver;
- internal bleeding;
- cardiosclerosis, cerebral arteriosclerosis, aortic aneurysm;
- coronary insufficiency, arterial hypertension of the II – III stage, preinfarction and postinfarction states;
- diseases of the central nervous system of an infectious and chronic nature;
- state of acute psychosis and delirium;
- tuberculosis, emphysema.
The list of contraindications is very extensive. Almost all of them are absolute, that is, even if the expected benefit from the reception is high, it is still forbidden to take Esperal.
The instruction for Esperal reports that there are indirect contraindications (those in the presence of which the drug is possible after consulting a doctor and adjusting the dose):
- past psychoses that arose on the background of the use of Esperal, Teturam, or Antabus;
- hypothyroidism;
- residual effects after a stroke;
- some pathologies of the brain of an organic nature;
- some mental disorders (bipolar disorder, MDP, some forms of schizophrenia).
The more competent and experienced narcologist will prescribe the drug, the better. Over the decades of practice developed with people suffering from drug and alcohol addiction, these doctors have developed a special "scent": will there be any sense in prescribing drugs with disulfiram in each case.
Side effects while taking with alcohol
The instruction for Esperala states that therapy should begin at least seven days after withdrawal from drinking or drinking alcohol. That is, from the moment of drinking, at least seven days should pass. Otherwise, the toxic load on the liver increases.
From the first day of therapy, the intake of ethanol-containing drinks is strictly prohibited. You can’t eat chocolate with cognac filling, drink non-alcoholic beer (0.5% ethanol in it), natural kvass, fermented compote, and medicinal alcohol tinctures. All of these drinks and products can cause a disulfiram reaction.
The instruction for drops "Esperal" reports that while taking the smallest doses of alcohol during treatment, the patient will experience the following:
- redness of the skin;
- indomitable vomiting (may lead to asphyxiation);
- severe headache, migraine;
- a sharp increase in pressure;
- the possibility of a heart attack, stroke (in proportion to the amount of alcohol consumed) increases;
- loss of consciousness, fainting, alcoholic coma;
- intoxication and damage to internal organs.
Esperalia torpedo treatment of alcoholism
This method of treatment is popularly called "coding", "binder". Its essence is that a special ampoule with Esperal gel is sutured into the muscle tissue of the patient. The instruction warns that such a method should be coordinated with the patient himself and in no case be carried out without his knowledge.
The torpedoing algorithm:
- the patient prepares for a week - does not take a single gram of alcohol, leads a relatively healthy lifestyle;
- on an appointed date he comes to an narcology on an empty stomach, he is measured blood pressure and, if necessary, blood is taken for hemoglobin and some infections;
- make excision with a scalpel of the site on the buttock or under the shoulder blade (those parts of the body to which independent access to extract the ampoule is problematic) and fix the drug in the muscle;
- suture the incision, treat the wound, apply a bandage.
An important point is whether the narcologist conducts a “relapse” procedure. It lies in the fact that the patient is given to make sure that the drug is real, and when drinking even a tiny dose of vodka (10-20 ml), a possible death awaits him.
For this, after half an hour after stitching the drug, a sick person is offered to drink half a glass of a strong drink. He drinks - and feels the whole "charm" of the disulfiram reaction.
Special Instructions and Medicines
The instructions for Esperal and reviews warn that the drug may not be compatible with certain groups of pharmacological agents.
Before using the drug, a biochemical blood test should be taken for liver tests (bilirubin, ALT, AST). If necessary, hepatoprotectors can be taken in parallel with Esperal therapy, they will support liver cells and reduce the toxic effects of disulfiram on the body.
If "Esperal" is taken simultaneously with indirect anticoagulants ("Warfarin" and others), then it is necessary to monitor INR and other blood coagulation indicators at least once a week at least once a week after taking it and 2 weeks after the end of its use. , in accordance with them, change the dosage of anticoagulants.
The opinion of narcologists of a similar therapy for alcoholism
Any harmful addiction is a complex process, which is not so easy to suppress by volitional effort. It seems to healthy people that stopping alcohol abuse is simple, but for a sick person this is a difficult and sometimes impossible task. People lose their jobs, real estate, families and still continue to drink, committing an act of suicide, stretched out over time.
Narcology has long recognized the fact that alcoholism is an incurable disease that always inevitably leads to death. There is no magic pill for alcoholism. To achieve remission (note - not to cure completely, but to achieve a temporary retreat of the disease) is possible only under one condition - if the patient himself is interested in this. But even if a person sincerely wants to be cured, his goal will not necessarily be achieved.
Narcologists consider Esperal and analogues (instructions for use confirm this) as one of the most useful drugs in the treatment of alcoholism. But only on one condition: the patient is aware and understands the principles of the disulfiram reaction and is fully responsible for the possible consequences.
Testimonials of people who have experienced the action of "Esperal"
Thanks to this drug, hundreds of thousands of people have become easier to get rid of their ailment. Let for a while: for five, ten years, but they have gained the possibility of a full existence. Patient reviews confirm that many of them after the course of treatment were able to achieve many years of remission and never returned to their dependence.
Alas, not everything is so rosy: some patients did not take seriously the warnings of narcologists about the consequences of drinking with Esperal. This made some frivolous patients disabled, some went to a better world. Before the encoding, as a rule, the patient signs a contract with a medical organization that he is warned about the consequences of his choice.