Alcohol and Teens (cont.)
Roxanne Dryden-Edwards, MD
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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What is the treatment for alcoholism?
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There are few medications that are considered effective in treating alcoholism. Zofran (ondansetron) has been found to be effective in treating alcoholism in people whose problem drinking began before they were 25 years old. Naltrexone (Trexan, ReVia, or Vivitrol) has also been found effective in managing alcoholism. Naltrexone is the most frequently used medication in treating alcoholism. It decreases the alcoholic's cravings for alcohol by blocking the body's euphoric ("high") response to it. Naltrexone is either taken by mouth on a daily basis or through monthly injections. Disulfiram (Antabuse) is prescribed for about 9% of alcoholics. It decreases the alcoholic's craving for the substance by producing a negative reaction to drinking. Acamprosate (Campral) works by decreasing cravings for alcohol in those who have stopped drinking. However, none of these medications have been specifically approved to treat alcoholism in people less than 18 years of age. Some research indicates that psychiatric medications like lithium and sertraline (Zoloft) may be useful in decreasing alcohol use in teens who have another mental-health disorder in addition to alcohol abuse.
There are numerous individual treatments for alcoholism in teens. Relapse prevention uses methods for recognizing and amending problem behaviors. Individualized drug counseling specifically emphasizes short-term behavioral goals in an attempt to help the individual reduce or stop the use of alcohol altogether. Cognitive therapy techniques, like helping the teen recognize what tends to precede and follow their episodes of alcohol use, are often used to address alcohol abuse in teens. Some treatment programs include drug testing. Twelve-step programs like Alcoholics Anonymous are individualized drug-counseling methods. Motivational enhancement therapy encourages the teen to increase their desire to participate in therapy. Stimulus control refers to a treatment method that teaches the person to stay away from situations that are associated with alcohol use and to replace those situations with activities that are contrary to using drugs. Urge control is an approach to changing patterns that lead to drug use. Social control involves family members and other significant others of the alcoholic in treatment.
While group therapy can be helpful in decreasing alcohol use in teens, groups that include a number of teens who also engage in disordered behaviors can actually tend to increase alcohol use in this age group. Family interventions for alcoholism that tend to be effective for teens include multidimensional family therapy (MDFT), group therapy, and multifamily educational intervention (MFE). MDFT has been found to be quite effective. Longer-term residential treatment of three to five months that addresses peer relationships, educational problems, and family issues is often used in treating alcoholism in teens.
For youth in the first stage of alcohol use (having access, but not having yet used alcohol), preventive measures are used. Therefore, limiting access to alcohol or other drugs, addressing any risk factors of the youth or family, as well as optimal parental supervision and expression regarding expectations are often recommended. The approach to those who have experimented with alcohol should not be minimized by mental-health professionals, since infrequent use can progress to the more serious stages of alcohol use if not addressed. Therefore, professionals recommend that the youth be thoroughly educated about the effects and risks of alcohol, that fair but firm limits be set on the use of alcohol, and that the user be referred for brief counseling, a self-help group, and/or family support group. Teens who have progressed to the more advanced stages of alcoholism are typically treated intensively, using a combination of the medical, individual, and familial interventions already described.
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Alcohol and Teens - Personal Experience Question: At what age did you start drinking? Was peer pressure a contributing factor? Please share your story.
Alcohol and Teens - Signs and Symptoms Question: What were the signs and symptoms associated with alcohol intoxication in you, a friend or your child?
Alcohol and Teens - Parental Prevention Question: As a parent of a teen, how do you try to prevent alcohol use and/or abuse?
Alcohol and Teens - Causes and Risks Question: If known, what were the risk factors for developing alcoholism as a teenager?
Alcohol and Teens - Treatment Question: What kinds of treatment were helpful in treating your teen alcohol problems?
Alcohol and Teens - Help for Teens Question: Was there a counselor, group, or organization that helped you with your alcohol problems? Please share your experience.