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#alcohol use disorder
neuroticboyfriend · 7 months
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this just in! substance use disorders don't exist only when someone uses substances. there are a bunch of other experiences that come with a substance use disorder. this includes cravings, withdrawal (physical and psychological), tolerance, dependency, obsessions with substance, anhedonia, needing to recover from use, and more! recovery isn't as simple as not using substances (especially since not everyone's recovery involves not using)! and, as with other conditions, it is still possible to lead a fulfilling life without full recovery <3
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smashing-yng-man · 4 months
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I've done it all - attended Alcoholics Anonymous twice a day, five days a week. Memorized the fourth edition of the "Big Book" from cover to cover. Admitted myself into two different rehabs, staying 60 days each time.
What has ultimately kept me sober from drinking is confiding in my therapist and taking a combination of Acamprosate and Naltrexone twice a day to curb alcohol cravings.
I drank heavily for nearly two decades, and frankly have the experience and genetic predisposition to confirm that addiction is not a choice.
But sobriety and self-care are.
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carrotzcake · 4 months
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My therapist acknowledged my progress today. He didn’t just say that, or that he was proud of me. He gave specific examples and feedback that demonstrated that despite a dangerous drinking episode over the weekend, the way I’m responding to it shows a new level of insight. That means so much to me. I was so afraid of his reaction, I now realize. So many others respond so judgmentally, negatively in the wake of my problematic alcohol use, force me into AA or consider HLOC. We’re also supposed to start trauma therapy & EMDR and I was worried this would postpone his decision that I’m ready.
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outstanding-quotes · 2 years
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Your child might say, “I hate my father!” For you to say, “You shouldn’t hate your father, he is sick,” is to lay guilt on the child. What a terrible person he must be to hate someone who is sick. It is better to explore the feelings with the child. “I know what you mean. Sometimes I think I hate him too, but it is really the disease [alcohol use disorder] that I hate. What I really hate is the way the disease makes him behave.” Help to clarify.
Janet Geringer Woititz, Adult Children of Alcoholics
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livewelltalk · 2 years
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The connection between alcohol and depression and the two conditions may feed off one another. If you’re battling depression, alcohol isn’t going to make you feel better. When treating depression and alcohol abuse, consult with a mental health professional and/or an addiction specialist who can provide resources and recommendations for possible treatment and/or rehab options. Click to know more → Alcohol and Depression: Withdrawal, Treatment, Rehab, Dual Diagnosis Treatment, How to Get Help
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mcatmemoranda · 2 years
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Pts with EtOH use disorder often have low phosphate because they don't eat. They also have low vitamin D intake-> secondary hyperparathyroidism-> high urinary phosphate excretion. Their serum phosphate may appear normal due to extracellular shift of phosphate. When you feed them or give IV fluids with glucose, insulin causes phosphate to shift intracellularly, so their phosphate level decreases. Respiratory alkalosis also shifts phosphate into cells. Rhabdomyolysis can occur from hypophosphatemia. Check CPK level. Pts with EtOH use disorder often have myopathy, so hypophosphatemia + myopathy-> symptomatic rhabdomyolysis.
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thefirespiral-blog · 2 years
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I haven’t had a drink since Tuesday, May 18, 2021. I didn’t even have a good last hurrah - it was cheap saké that I warmed in an oversized bottle in a small pan of water - y’know, like syrup - and local hard cider. I know I drank all the cider (a tall can, maybe more than one) and I think I drank most of the saké. Some people plan that last drink with some ritual, but I, well, I didn’t. I passed out fell asleep just like any other night. I’m sure I told myself I was done drinking, or something like it before I drifted off. No ritual at all. Just the same ol’ same ol’. I had no idea what was coming in the morning.
For some people, my decision to stop drinking and using cannabis seemed to come out of nowhere. I’d actually been working on it - mostly without awareness - for decades. Every spiritual thing I’d ever done, every therapy session I attended, every moment of insight, every book about trauma, body love, self-love, growth, every political awakening, every experience, every lifequake, every deep conversation I’d had to that point - these things and more all led me to sobriety. 
In 2021, I woke up on Wednesday, May 18th at 8 AM. After snoozing as much as I could, pushing through feeling like absolute shite (as usual), and winning the debate about whether I felt up to going to work (mostly usual), I followed the rest of my morning routine. That consisted of reviewing how much I’d drank the night before, how terribly I’d slept, and how awful my stomach felt.  I checked my phone and social media to make sure I hadn’t said or posted something I regretted. Somehow, on this particular day, when I swore to stop drinking, it was like an oath to the godds. I knew I was done. I was never going to drink alcohol again. 
Prior Attempts
I was newly 40 when my dad died unexpectedly in 2011. He was only 61, and there is absolutely no doubt that a lifetime of hard drinking, many drugs, and a two-pack-a-day cigarette habit had a lot to do with that. For the first time, I felt my own mortality, the sense that I really don’t have forever to do the things I want to do or to live the life I wanted to live. I entertained the idea that I had a drinking problem, though not for the first time. 
The first time I realized my drinking was not normal happened years earlier, in the wake of losing Jasmine. Jasmine was my 10-year-old daughter, lost to complications from a lung transplant in 2004. By late 2005 I was drinking up to 2 bottles of wine per day, and somehow still managing to hang onto a full-time job - just barely. I had no PTO and my attendance was a regular talking point in reviews. I was not, however, doing a great job of hanging on to my marriage, parenting, being a friend, or much of anything else. My life was an absolute train wreck, the proverbial hot mess. My playlists often included hits such as “Where is My Mind,” and “Something Is Not Right With Me,” and “I Need Some Sleep” and endless replays of the entirety of The Fragile. (Pixies, Cold War Kids, The Eels & Nine Inch Nails, respectively)  When I look back now, I often feel like I need to apologize endlessly to the people who loved me in my 30’s and early 40’s. I was seriously out of my fucking head with grief and figuring out who I was. Thank the godds for you all, you know who you are. From the heart, I wouldn’t be here without you. Especially Jeff.
I did a month without alcohol at the behest of my counselor in 2006 or so. I was successful, but it was challenging when I visited my family and tried to explain why I wasn’t drinking. Generally speaking, it was a dynamic in my family that drinking and smoking weed was a group activity.  To not do so was not only a betrayal of how we interacted but also an indictment of the decision to drink. If I said I wasn’t drinking, that was like saying I didn’t want to be part of the family and that I was judging and insulting their drinking and drug habits. I managed to do the time my therapist and I agreed upon… and not much more than that. Between my mental and emotional health and my social situation, it was too hard not to drink. 
Fast forwarding to my dad’s death in 2011, it became harder to ignore my drinking. I “experimented” with AA in early 2012 - trying it for six months for a class project. I again left myself an “option” of starting to drink again at the end of that time if I “felt like” I could do it without having a problem. Naturally, that means I was drinking again as soon as my class project ended. I totally hung in for that entire six months, didn’t drink, attended 2-3 meetings a week, hated most (all) of the program literature. I learned that AA was (and is) not a good fit for me, but also to be completely honest? I wasn’t ready to quit yet. I especially wasn’t ready to quit if AA was the way I had to do it - all I wanted to do after I left those meetings was have a glass (or let’s be real, a bottle)  of wine.  I looked into SMART Recovery at the same time, but I couldn’t find any meetings that I could attend. Remember this was pre-Zoom era, so in-person was really the only way to go for support meetings. I also really worried about my relationships and what would happen if I dropped out of social drinking. I was afraid no one would really think sober me was much fun and I would end up isolated and alone.
In December 2020 I received some bad health news - I was starting to show signs of liver damage, signs that made it so I could no longer ignore or deny the impact my drinking was having on my health. Not just my physical health, mind you, but emotional, mental, and spiritual health as well. So I tried to stop drinking on my own. 
I tried moderation first, making rules and agreements that didn’t even last a week. I always had a reason why any given day was exceptional and I should “bend” the rule and drink. While I didn’t always get drunk when I was drinking during this time, it had been many, many years since I’d gone more than a few days without a drink. Even when I was really sick, I would rationalize reasons why I should drink anyway. “The alcohol will kill the bad germs in my gut.” “Whiskey toddies are just the thing for a cold!” “I have a sore in my mouth - definitely need to clean it out with some whiskey.” The lies I told myself - that I knew were lies - were ridiculous. When I think about it now, those lies make me cringe, but mostly I recognize them as a symptom of struggling to come to terms with alcohol use disorder.
2021
Back to that particular day in 2021 -  I knew I was done but that I couldn’t deal with it on my own, especially not while working full time and managing a house full of people. I looked for a local treatment center and found Awakenings By the Sea, a women-only in-patient facility that was less than 20 miles from home. I called and spoke to the intake coordinator before I went to work that Wednesday morning. She assured me I could participate without having to use the 12-step model. I got the logistics in order, took some books and other tools to work my own recovery program, and told my family and coworkers that I needed to be gone for a while. My boss moved heaven and earth to make it so I could enter for a 30-day visit within 4 days. I will forever be grateful to him for helping get my Self back. I checked into treatment on Sunday, May 23, 2021. I was terrified. I needed to be there. And I was, in the end, awakened.
Reflections on The Work
I have spent the past 12 months doing so much work - hard work - on myself. Work that honestly? I think anyone could benefit from regardless of their alcohol/substance use status. Plenty of other behaviors arise from the same roots as addiction - workaholism, orthorexia, codependency, etc. They’re called process addictions, and they’re just another way of coping that becomes harmful. I think these are ubiquitous and especially lethal because they are often rewarded. They destroy relationships, lives, health, finances… all the same things that substances destroy.
I stopped using cannabis and psychedelics at about the same time as alcohol - my last day of using was May 20, 2021. I wasn’t sure if I would continue to use cannabis after I stopped drinking. I hadn’t made up my mind completely even when I left treatment. While I had some spiritual experiences with cannabis and some mushroom/LSD microdosing, I realized that mostly, I was using these things to cope (badly) with trauma. I know that for the foreseeable future, I cannot guarantee that I wouldn’t start to use them to do that if I were to try them again. I have not ruled out future use for spiritual journeying, but I have to say I can’t currently see my way to doing so safely.
Between 2021 and 2022 I have surprised myself over and over. I have felt feelings that I’d rather not feel, but NEEDED to feel. I have taken an unflinching look at myself and that shite ain’t easy. I have touched my shadow, shined a light on it, healed what I could, and honored the rest. Getting sober isn’t easy. But I can’t believe how much better my life is for doing it. I would never have believed it before going through this past year myself. I remember scoffing, again and again, at people’s stories of how sobriety changed their lives in miraculous, magickal ways. What I know now is that it’s not a miracle and it’s not magick. It’s not an act of God or godds. It’s me giving a fuck about myself. Loving myself. Working hard. Seeing that I am, in fact, pretty awesome. Healing. Wanting to be clear for myself and only myself. It’s me knowing why I don’t drink and never questioning that decision.
One year later there has been so much change. Even as the external world feels like it’s falling apart (and it is, in many ways) my life has become different in all the RIGHT ways. I learned that being 100% present, living my life the way I always dreamed was actually possible. I learned (and am learning) so many things.
5 Incredible Things About Being Sober
I love and experience wonder about the person I am. In the past 12 months, I have learned more about myself and how to build the life I want to live than I learned in the last 12 years. I built a platform for sobriety and for truly loving myself in my work with Reclaiming Tradition Witchcraft and Diana’s Grove. My sobriety rests solidly on that work, and I continue to experience and learn in that spiral pattern, coming back to old lessons and learning new things over and over. I’m remembering and discovering what brings me joy. I’m figuring out what actually matters instead of what “should.”
I discovered that there are mental health diagnoses that were hiding under alcohol use disorder - things like bipolar II and rejection sensitivity dysphoria. I learned that what has long been a diagnosis of major depressive disorder is actually a component of bipolar II disorder. I’ve been having hypomanic cycles for years, masked by alcohol. My bank account can definitely testify to this, and so can my life partner. Though C-PTSD was diagnosed well before I stopped drinking, I have a fuller sense of how the trauma has impacted and continues to impact me. Learning about trauma, how it lives in the body, and how it was part of my alcohol use disorder helped lay the background for healing my disordered eating and alcohol use. I’m still learning about trauma and will be for the rest of my life. I think being trauma-informed is as necessary as critical thinking in both my personal world and the world at large.
Thanks to DBT (dialectical behavioral therapy) and CBT (cognitive behavioral therapy), I’ve gathered many tools for emotional regulation, mindfulness, and generally processing my emotional reaction to things. I’ve successfully learned new ways (and gotten better at old ways) of feeling my feelings, honoring them, and giving them space before I engage with anyone or anything. I used to believe I was hopeless - never going to be able to be good at dealing with my emotions. I drank to drown them. These are the most important tools I’ve honed (and continue to hone) for sobriety. I’m learning how to advocate for myself, and how to know something is true for me without needing it to be validated by someone else. The concept of standing in my truth used to be nebulous to me, but it’s become more and more clear and defined since I decided to live without alcohol.
I take better care of my body. I take my prescribed medications and supplements on a regular schedule. I practice intuitive eating and enjoy delicious, nourishing food. I move my body more: fitting in little walks, being more physically active at work, taking the long way to get to things. My sleep - which is critical to, like, everything about my health, improved considerably. I’ve known for a long time that alcohol really fucks with your sleep, both from reading about it and experiencing it. Even still, I had no idea how much it would improve over time when I stopped drinking. I have sleep issues related to trauma anyway, but my sleep is 100% better than it was when I was drinking, even if it’s not 100% as good as most people’s.
I still have an aging body with some diagnoses that will likely never go away. Gravity is real, aging is a bitch, things fall apart, you know the drill. That said, all of those diagnoses are much improved. My liver, after sounding the alarm with pain and swelling, is now healed. I have more energy. I don’t forget as many things, and when I do, I know for damned sure it’s not because I was under the influence of alcohol or anything else. My brain healed tremendously after decades of drowning in wine. And it’s still healing, as is the rest of my body. It takes a long time to recover from alcohol use disorder. 
I’m more honest and thoughtful in my relationships and interactions. I have a buffer between my emotions that comes from a deep peace and wisdom I never had. My reaction is more balanced and in alignment with my values - I am more grounded than ever before. While I still have moments of wishing I’d dealt with a situation differently, most of the time I feel good about how I handle the hard conversations. I stand firmly in my truth these days, even as I can be receptive and compassionate to other truths. I take my time before I respond to situations, especially when they’re emotionally charged. I speak now with conviction rather than self-doubt and a lack of clarity. I am more accountable and less flaky. I’m a better friend, a better partner, a better parent, a better aunt - better at all these things because I don’t feel so fucking unhinged and reactive.
My marriage, well. Jeff is either crazy or a saint for sticking with me through this: ::flails wildly at the past three decades:: Maybe both. Aren’t most saints crazy? Anyway, the guy stuck around despite my best attempts to drive him away. I wasn’t coping with trauma well, or at all, actually. I was just trying to drown it. Glad I’ve learned better. I’m hoping to spend the rest of my life showing Jeff it was worth it to stick around. Not drinking has made our relationship better in about a million ways. For me, that means we’re closer and our conversations are more balanced. I have been relinquishing the need for power and control for many years, but when I stopped drinking, I cut the last bits away. Part of this story is Jeff’s, and he can tell it - or not - as he wishes. I love you so much, Jeff. Definitely don’t deserve you, am glad I regained my sanity for the rest of our lives. We both know that a relationship that lasts long is rarely, if ever, easy. They take work. We’re pretty muddy from it, aren’t we? But look what we have created, this kintsugi of a relationship.
I have made new, wonderful friends in my journey and/or have renewed or deepened existing friendships. The power of community always prevails, even for us introverts. As is often the case, a few relationships changed and some kinda fizzled out. Some relationships have been ended because they were toxic. I don’t love that, but also, I am not willing to sacrifice myself to change it. And…this is a tiny number of relationships. Mostly I’ve made some authentic connections with people that I just wouldn’t have been able to make when I was drinking. My life is just so much clearer now. And of course, I had also damaged - sometimes irreparably - many relationships while under the influence. At least now I know if I’m the asshole it ain’t ‘cause I was drinking.
There are SO many more ways to get sober besides the 12-step model. Thank the godds I have always remained an active, avid reader - it was a book that showed me the way to the program that ultimately worked for me. I started with a book/program that was a feminist, empowered modification of the 12-step model (“Many Roads, One Journey'' by Charlotte Kasl). I found something even better while I was in treatment - the Tempest program (it’s online). This program was created by Holly Whitaker, who wrote “Quit Like A Woman,” and it is a very trauma-informed, science/evidence-based and progressive program.** 
There’s never been a time of more choices to reach sobriety than now. It’s pretty fucking fantastic. At one point, I was participating in meetings from The Luckiest Club (based on Laura McKeown’s work), Soberful (based on Veronica Valli’s work), Recovery Dharma and SMART Recovery. All of these have robust online presences - no local group is required to participate and benefit. And there are SO MANY great podcasts out there! If the 12-step model works for you, that’s great! But it is so very important that people know that isn’t the only way, nor should it be the default setting for how to get sober.
I am creating the life I’ve always wanted. Since I quit drinking, I have rediscovered the facts that I live in the place I always wanted to live in (the Pacific Northwest), that my house is the home I always dreamed of (an older two-story with lots of trees and green growing things all around), and that I now am doing the work I always wanted to do! Way back in 1996 I responded to an interview question about where I saw myself in 20 years. I said that I would be finished with my college degree and working in a women’s shelter where I could help women rebuild their lives following violence and substance abuse. And here I am! My 20-year timeline was off - mostly due to my drinking - but I made it. I fucking made it and the naysayers… well they don’t deserve the energy of me calling them out. 
Some details have been modernized - the DV/IPV center where I work helps people of all gender identities and orientations. We are rooted in being anti-oppression and trauma-informed, empowering survivors to find the best solution for themselves. I share deep values with my co-workers. And now with the new position, I live openly as a polytheist, animist Witch. I don’t censor myself or worry about whether it’s safe to talk about what matters most to me. I can claim my sexuality. My work environment is trauma-informed, caring, and incredibly supportive.  I get to do meaningful work every day, work that supports the change I’d like to see in the world. Fuck yes! I did it! Here I am! And most of the time, I have the presence to remember and revel in it.
**Right after I wrote this essay, I received an email that Tempest is being acquired by Monument, which feels a lot like it’s going to lose what is really special about it. Monument – well, the name kind of says it. Bigger with more medical services, but less in the way of individual support and less in the way of all the things that made Tempest my lifeline this past year. That makes me sad, but in learning that, I also learned that Holly Whitaker was basically forced out of being part of Tempest last year, and now I’m having all kinds of feels about that too. All of that said, there is a wonderful FB group that revolves around “Quit Like a Woman” - complete with regular meetings and insightful community providing support no matter where you are in the process of quitting. I highly recommend it.
Also, it says a lot to me that while I am having feels about the end of this particular resource, I am not having concerns about finding other communities and ways to support my sobriety. I am not having worries about keeping my sobriety because it is based on a very individualized program that I created for myself using their framework. Meetings were essential at the beginning, and are nice now, but they are not the core of me keeping my sobriety. And if I want to find a meeting, there are plenty of options out there.
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dexrlybel0ved · 1 month
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more caffeinated so a bit better but man the only thing ik would help is alcohol
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neuroticboyfriend · 7 months
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something nobody tells you about substance use disorder is that if you get cravings it's possible for them to present as olfactory (scent) and gustatory (taste) hallucinations. for example, i will smell alcohol, vapor, sometimes even post nasal drip, when there. is none. or i'll taste alcohol in drinks i usually mix alcohol with, even though they contain no alcohol. cravings can honestly just register as hunger and thirst but Different, too.
this may also intersect with the fact i'm schizophrenic but um. yeah. that's a thing! now you know.
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smashing-yng-man · 4 months
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carrotzcake · 5 months
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wild that there's evidence of behaviors but no memory of it
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sabrrfoundationindia · 5 months
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headlinehorizon · 5 months
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Weight Loss Drugs Show Promise in Reducing Alcohol Use Disorder Symptoms, Study Finds
A recent study suggests that weight loss drugs like Ozempic and Wegovy may help reduce symptoms of alcohol use disorder (AUD). The study found significant decreases in AUDIT scores for patients undergoing semaglutide treatment, indicating a potential benefit for those struggling with alcohol intake.
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theobviousparadox · 5 months
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Review: Learning to Fall by Sally Engelfried
Learning to FallSally EngelfriedLittle, Brown Books for Young ReadersPublished September 6, 2023 Amazon | Bookshop | Goodreads About Learning to Fall Twelve-year-old Daphne reconciles with her father, who left her stranded three years ago and learns forgiveness one fall at a time in this heartwarming debut by Sally Engelfried. For fans of The​ First Rule of Punk. Daphne doesn’t want to be…
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mcatmemoranda · 2 years
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I'm listening to episode 292 of Frany Speaking About Family Medicine - Reducing the Risk of Alcohol-Associated Liver Disease
14 grams of alcohol is a standard drink. That's 5 oz of wine, 12 oz of beer, or 1.5 oz 80-proof liquor. More than 7 drinks in 1 week or more than 3 in one day is excessive drinking for women. More than 14 drinks in one week or more than 4 drinks in one day is excessive drinking for men. Basically, women should drink 1 or no alcoholic beverages daily and men should drink no more than 2 drinks daily.
Alcohol use disorder = continued use despite harm. There are 11 criteria* for EtOH use disorder; the pt must meet 2 of the criteria in an 12-month period. It leads to clinically significant impairment or distress.
Ask about the pt's motivation to quit or cut back on his/her drinking to help guide treatment. Ask if the pt has ever experienced any symptoms of alcohol withdrawal (headache, palpitations, tremors, hallucinations) to help determine whether the pt is a candidate for output vs. inpatient withdrawal. For pts who have experienced seizures, hallucinations, DT, if they have a CIWA score of more than 15, are medically complex, or are pregnant, they should be inpatient for withdrawal treatment.
-4 to 6 out of the 11 criteria = moderate alcohol use disorder.
-6 or more out of 11 criteria = severe alcohol use disorder; recommend medical and psychosocial treatment
Naltrexone is a good first line treatment as long as the pt isn't taking opioids. It comes in oral and IM forms. It reduces cravings for alcohol.
Acamprosate is another option, but pts need to achieve abstinence before starting it and it's dosed TID.
Disulfiram, gabapentin, topiramate, and baclofen are other drugs that can be used to treat EtOH use disorder.
*the 11 criteria for AUD:
-You drank more, or longer, than you meant to
-Craved alcohol badly
-Tried or wanted to drink less, but couldn’t
-Gave up or cut back on activities you used to enjoy, so you could drink instead
-Spent a lot of time drinking or recovering from a hangover
-Repeatedly placed yourself in risky situations during or after drinking
-Had problems at home, work, or school because of drinking or hangovers
-Continued to drink even when it negatively affected your personal and professional relationships
-Kept drinking even though it made you feel anxious or sad
-Had to drink more to feel the desired effect, or felt much less of an effect from your usual number of beverages
-Experienced shaking, restlessness, anxiousness, nausea, or other withdrawal signs when the effects of your drinks wore off
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