Hopp til hovedinnhold

Alkoholavhengighet

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Er en alvorlig og ofte langvarig tilstand assosiert med en sterk og vanskelig kontrollerbar trang til å innta alkohol
Forekomst:
Prevalens av alkoholavhengighet regnes å være ca. 4-5% av befolkningen i vestlige land
Symptomer:
Sykehistorien er karakterisert ved overforbruk av alkohol både over lengre tid og som hyppige kortvarige episoder
Funn:
I tidlig fase er det ingen kliniske funn. På lengre sikt inntrer utfall fra en rekke organsystemer
Diagnostikk: 
Skadelig forbruk kan utredes med GT, ALAT, PEth, ev. CDT
Behandling:
Fundamentet i behandlingen er erkjennelse av problemet, og motivasjon for å slutte med misbruket
  • Nasjonal kompetansetjeneste for tverrfaglig spesialisert rusbehandling - TSB 
  • Nasjonal kompetansetjeneste for samtidig rusmisbruk og psykisk lidelse - ROP 
  1. Folkehelserapporten. Rusbrukslidelser i Norge. Folkehelseinstituttet, oppdatert 06.12.2019. fhi.no  
  2. Skjøtskift S. Alkohol som medvirkende faktor i noen vanlige kliniske situasjoner. Tidsskr Nor Lægeforen 2003; 123: 185-7. PubMed  
  3. O`Dowd. Alcohol accounts for 6% of all admissions til English hospitals. BMJ 2008; 337: a963. PubMed  
  4. Tolstrup JS, Nordestgaard BG, Rasmussen S, Tybjærg-Hansen A, Grønbæk M. Genetisk variation i alkoholdehydrogenase, alkoholdrikkevaner og alkoholisme - sekundærpublikation. Ugeskr Læger 2008; 170: 2672. PubMed  
  5. Schumann G, Liu C, O'Reilly P, et al. KLB is associated with alcohol drinking, and its gene product β-Klotho is necessary for FGF21 regulation of alcohol preference. Proc Natl Acad Sci USA 2016; 113:14372. doi: 10.1073/pnas.1611243113 DOI  
  6. Crawford MJ, Patton R, Touquet T, et al. Screening and referral for brief intervention of alcohol-misusing patients in an emergency department: a pragmatic randomised controlled trial. Lancet 2004; 364: 1334-9. PubMed  
  7. Brown RL, Saunders LA, Bobula JA, Lauster MH. Remission of alcohol disorders in primary care patients. J Fam Pract 2000; 49: 522-8. PubMed  
  8. Braut GS. Krav til rusmiddelarbeid i helsetenesta. Tidsskr Nor Lægeforen 2003; 123: 49-51. PubMed  
  9. Nordlie E. Alkoholmisbruk - hvilke konsekvenser har det for familiemedlemmene?. Tidsskr Nor Lægeforen 2003; 123: 52-4. PubMed  
  10. Winslow BT, Onysko M. Medications for alcohol use disorder. Am Fam Physician. 2016 Mar 15;93(6):457-465.
  11. Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings. A systematic review and meta-analysis. JAMA 2014; 311: 1889-900. doi:10.1001/jama.2014.3628. DOI  
  12. Pettinati HM, Oslin DW, Kampman KM, et al. A double-blind, placebo-controlled trial combining sertraline and naltrexone for treating co-occuring depression and alcohol dependence. Am J Psychiatry 2010; 167: 668-75. American Journal of Psychiatry  
  13. Pani PP, Trogu E, Pacini M, et al. Anticonvulsants for alcohol dependence. Cochrane Database Syst Rev. 2014 Feb 13;2:CD008544. The Cochrane Library  
  14. Malcolm R, Myrick H, Roberts J, Wang W, Anton RF, Ballenger JC. The effects of carbamazepine and lorazepam on single versus multiple previous alcohol withdrawals in an outpatient randomized trial. J Gen Intern Med 2002; 17: 349-55. PubMed  
  15. Johnson BA, Ait-Daoud N, Bowden CL, et al. Oral topiramate for treatment of alcohol dependence: a randomised controlled trial . Lancet 2003; 361: 1677-85. PubMed  
  16. Anton RF. Naltrexone for the management of alcohol dependence. N Engl J Med 2008; 359: 715-21. PubMed  
  17. Rösner S, Hackl-Herrwerth A, Leucht S, Vecchi S, Srisurapanont M, Soyka M. Opioid antagonists for alcohol dependence. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD001867. DOI: 10.1002/14651858.CD001867.pub3. DOI  
  18. Carmen B, et al. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction 2004; 99: 811-28. PubMed  
  19. Berglund M, Thelander S, Salaspuro M et al. Treatment of alcohol abuse: An evidence-based review. Alcohol Clin Exp Res 2003; 27: 1645-56. PubMed  
  20. Anton RF, O’Malley SS, Ciraulo DA, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE Study: a randomized controlled trial. JAMA 2006; 295: 2003-17. Journal of the American Medical Association  
  21. Bouza C, Magro A, Munoz A, Amate J. Efficacy and safety of naltrexone and acamprosate in the treatment of alcohol dependence: a systematic review. Addiction 2004; 99: 811-8. PubMed  
  22. Palpacuer C, Laviolle B, Boussageon R, et al. Risks and benefits of nalmefene in the treatment of adult alcohol dependence: A systematic literature review and meta-analysis of published and unpublished double-blind randomized controlled trials. PLoS Med. 2015. doi: 10.1371/journal.pmed.1001924 DOI  
  23. Mørland J. Legemidler mot alkoholmisbruk. Tidsskr Nor Lægeforen 2006; 126: 3268-9. PubMed  
  24. Heilig M, Egli M. Pharmacological treatment of alcohol dependence: Target symptoms and target mechanisms. Pharmacol Ther 2006; 111: 855-76. PubMed  
  25. Rosner S, Hackl-Herrwerth A, Leucht S, et al. Acamprosate for alcohol dependence. Cochrane Database of Systematic Reviews 2010; 9: CD004332. Cochrane (DOI)  
  26. Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings. A Systematic Review and Meta-analysis. JAMA. 2014 14;311(18):1889-900. doi: 10.1001/jama.2014.3628. DOI  
  27. Mann K, Lehert P, Morgan MY. The efficacy of acamprosate in the maintenance of abstinence in alcohol dependent individuals: Results of a metaanalysis. Alcohol Clin Exp Res 2004; 28: 51-63. PubMed  
  28. Namkoong K, Lee BQ, Lee PG et al. Acamprosate in Korean alcohol-dependent patients: A multi-centre, randomized, double-blind, placebo controlled study. Alcohol Alcohol 2003; 28: 135 - 41. PubMed  
  29. Johnson BA, Rosenthal N, Capece JA, et al, for the Topiramate for Alcoholism Advisory Board and the Topiramate for Alcoholism Study Group. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA 2007; 298: 1641-51. Journal of the American Medical Association  
  30. Mason BJ, Quello S, Goodell V, et al. Gabapentin treatment for alcohol dependence: A randomized clinical trial. JAMA Intern Med 2013. doi:10.1001/jamainternmed.2013.11950 DOI  
  31. Foster T. Editorial. Dying for a drink. BMJ 2001; 323: 817-8. PubMed  
  • Ingard Løge, spesialist i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Svein Skjøtskift, spesialist i psykiatri, overlege, Bjørgvin Familierådgivningskontor, Bergen