Alcohol

BY Frank Spinelli, M D

April 16 2010 4:15 PM ET

 Many people consider themselves “social drinkers” because they do not drink every day; however, drinking excessively on the weekends can also qualify as abuse. That is why it is so important to realize that you do not need to drink every day to have a problem. Also, some people can cease all alcohol consumption for days, weeks, or even months before they start drinking again. To consistently maintain control of your alcohol intake, once you have identified it as a problem, takes professional help and social support.

Naltrexone, an opioid receptor antagonist, is used primarily in the management of alcohol dependence. In 2006, the FDA-approved naltrexone extended-release injection under the brand- name Vivitrol, which is administered monthly by a health- care professional for the treatment of alcohol dependence. Vivitrol does not eliminate or diminish alcohol withdrawal symptoms but acts to reduce the craving for alcohol. The product is indicated for use with psychosocial support in patients who are able to abstain from drinking in an outpatient setting and are not actively drinking on initiation of therapy.

Alcoholics Anonymous is a very helpful resource in the treatment of gay alcohol dependence. A.A. meetings offer support as well as counseling, and they are not as religious as some people fear. Most cities even have gay, or gay- friendly, A.A. meetings, which is extremely helpful for gay clients who might not identify with heterosexuals. A.A. even has pamphlets for the gay alcohol dependent.

In addition to A.A., gay men with alcohol and drug issues should be referred for psychotherapy or counseling in order to get evaluated for depression and internalized homophobia. It is imperative that their support system be adequate to ensure their recovery. Recovering from alcohol and drugs often involves facing the same problems as anyone else who has gone through the process of recovery. Patients must learn to give up old friends and stay away from bars and other places that might instigate a relapse. Individuals undergoing recovery must learn to be comfortable without drugs and alcohol and accept a life without them. One of the most important aspects for gay men is learning to cope with the people around you who continue to use drugs and alcohol. Sometimes there is no escaping the temptation. Relapse is extremely common. Those people who do relapse should not be deterred and should get right back up and try again.





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