Q) I'm concerned about a friend of mine who regularly drinks to excess and may well be alcohol-dependent. Fortunately, he's admitted he has a problem and is seeking help from his GP. But I'd be interested to know what alternative medicine has
to offer for alcohol addiction.-C.C., via e-mail
A) Many of us overindulge in alcohol from time to time, especially during the festive period. But for some people, excessive drinking can take over their lives and lead to a number of serious health issues such as alcohol depend-ency, liver cirrhosis, gastritis, pancrea-titis, heart trouble, brain damage and cancer, to name but a few.
Alcohol addiction, a physical depen-dence on alcohol, occurs gradually as drinking alters the balance of brain chemicals such as gamma-amino-butyric acid (GABA), which inhibits impulsiveness, and glutamate, which excites the nervous system. Alcohol also raises levels of dopamine, which is responsible for the pleasurable aspects of drinking.
Long-term excessive drinking will eventually cause the body to crave alcohol to restore good feelings or avoid negative ones. Other factors-genetic, emotional, psychological and social-can also contribute.
According to the UK's Institute of Alcohol Studies, an individual is alcohol-dependent if he has three or more of the following within a year:
- a strong urge to drink, difficulty controlling how much is drunk or difficulty stopping once it starts
- physical withdrawal symptoms, such as sweating, shaking, agitation and nausea on reducing alcohol intake
- a growing tolerance to alcohol-in other words, needing larger quanti-ties to achieve the same effect
- gradual neglect of other activities
- persistent drinking even when it's obviously causing harm.
A separate disorder, alcohol abuse, is where, although there's no dependency on alcohol, enough is drunk to cause actual physical or psychological harm.
Your friend's GP can help determine the extent of the alcohol problem and may recommend counselling, support groups such as Alcoholics Anonymous, nutritional help, and certain drugs to induce and maintain abstinence.
However, if your friend is indeed alcohol-dependent, simply cutting down won't be enough.
A Canadian study found that 69 per cent of alcoholics were still clean and sober three months after undergoing treatment plus daily vigorous exercise. In contrast, 62 per cent of those who were treated, but without the exercise, relapsed (J Stud Alcohol, 1982; 43: 380-6). In another study, alcoholics in a physical-fitness programme with the usual treatment showed significantly less alcohol cravings than those receiving only standard treatment (J Psychosoc Nurs Ment Health Serv, 1997; 35: 39-45). Also, exercise can reduce the depressive symptoms associated with giving up alcohol, and boost self-esteem (J Subst Abuse Treat, 2001; 21: 199-206).
Acupuncture shows promise in alcohol-related disorders. A study of 80 severely recidivist alcoholics (who continue to abuse alcohol despite treatment) found that acupuncture reduced cravings, drinking episodes and admissions to detox better than sham acupuncture (Lancet, 1989; 1: 1435- 9). Patients reported that acupuncture had a definite impact on their desire to drink (Alcohol Clin Exper Res, 1987; 11: 292-5), and it's also a useful adjunctive treatment for reducing withdrawal symptoms (Addict Biol, 2002; 7: 415-9).
So, while not all studies show benefit, many alcohol-addiction pro-grammes report that patients appear to "like acupuncture" and wish to continue their detox programme for longer when acupuncture is on offer.
Another traditional Chinese medi-cine that can help to stop alcohol addiction is the herb kudzu (Pueraria lobata). In heavy drinkers, one week of kudzu treatment significantly reduced alcohol consumption compared with a placebo (Alcohol Clin Exp Res, 2005; 29: 756-62).
Other beneficial herbs are St John's wort (Hypericum perforatum), ibogo or bitter grass (Tabernanthe iboga), gin-seng (Panax ginseng), and red sage (Salvia miltiorrhiza) (Fitoterapia, 2000; 71 Suppl 1: S38-42). These should only be taken under the supervision of a herbal-medicine practitioner.
Homeopathic remedies such as Nux Vomica have also been used to treat alcohol-related problems. According to one review, "homoeopathy can provide a valid and effective therapy to help . . . break the cycle of dependence on alcohol" (Complement Ther Nurs Mid-wifery, 1997; 3: 21-8). A qualified homeo-path will be able to determine the appropriate remedy for your friend.
Dr Melvyn Werbach notes that many nutritional deficiencies may be caused by excessive drinking and alcoholism. "By improving nutritional status," he says, "not only may it be possible to prevent some of the diseases associated with alcoholism, but there is preliminary evidence that both alcohol craving and the symptoms of alcohol withdrawal may be ameliorated."
- Reducing alcohol-induced damage: protective nutrients include vitamins C, E and B-complex, magnesium, selenium and zinc, as well as amino acids, carnitine, catechin, choline, gamma-linolenic acid, glutathione, thiamine and pantethine.
- Reducing alcohol cravings: a well-balanced, nutritious diet that is especially high in raw foods may be beneficial. Reducing sugar and 'junk-food' intake, and avoiding caffeine may also help. Supplements that may reduce cravings include B-complex vitamins, zinc, nicotinic acid, glutamine and pantethine.
- Reducing alcohol-withdrawal symptoms: supplementation with evening primrose oil, gamma-hydroxybutyric acid or taurine may lessen or even prevent withdrawal symptoms.