My brother has a severe alcohol drinking problem, he is absolutely fine in the morning but once he drinks at night he cannot stop himself from drinking more and more, and after drinking he gets aggressive starts abusing howls all night but in morning he is absolutely fine goes to work. His Aggressive nature was an issue from a younger age. Please suggest something.
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Dear Anju, Rakesh seems to be intoxicated with alcohol. What you have described is only intoxication behaviour. He is normal without alcohol. Tell him you like him in the mornings. Motivate him to sleep without alcohol. Since alcohol is a sedative, when he stops drinking there is difficulty in sleeping. The brain gets used to the drinks. It will ask him to give drinks by disturbing his sleep. So, doctors' first medicine when he stops alcohol is a Calmpose kind of drug. There are many types of such drugs - both tablets and injections. Few act only for 2 hours, few acts longer than 24 hours. It will be given for 2-3 weeks initially, when he stops drinking, depending on his need. It is a drug to stop him from suffering withdrawal symptoms. It may be given throughout the day also for few days so that he will not go for alcohol immediately. He will also be given motivational enhancement therapy and stress management therapy in first 12 weeks. He can also start with anticraving drugs like Acamprosate, Baclofen and Naltrexone. They postpone his craving for alcohol. Not immediately - but in 3 months or so. They also make his brain to tolerate less and less alcohol. They are costly and need to be given for 9 months to a year in appropriate dose. He can also ask for aversion therapy with Disulfiram. It makes the alcohol into a poison. The effect of poison, he will no't like. He will be OK after taking the drug daily. The drug acts only when alcohol gets into his blood. Since the poison effect happens as soon as he drinks, he feel like not drinking or induce vomiting after drinking. This drug is cheap, only less than Rs.2/day. It can be taken for life. Better to assign someone who will give the drug daily to him. May be his wife or mother. All the other drugs he can take by himself.
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Alcohol dependence involves intense craving or desire to drink alcohol. People drink for pleasure or rationalize it on external factors like family problems, work tension, etc. They drink continuously, i.e. Almost daily or even weekly once or twice with withdrawal symptoms, tolerance, bodily damage, etc. You need to consult a psychiatrist and go for 3 steps of de addiction. 1st is detoxification, when alcohol is stopped and the withdrawal is made smooth with minimal discomfort, 2 nd is maintenance and further deaddiction when the physical problems and psychological state of the individual is maintained and anti-craving drugs started 3 rd rehabilitation, when relapse prevention is the goal, while maintaining deaddiction. All the best.
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