Q: Regarding my alcohol problem, I got the information about disulfiram; but I think it is quite dangerous since I am a hypertensive patient. Can you please enlighten me about naltrexon and where I should go for this treatment and if it is available in Gurgaon?

A:Compared with the alcohol you've been drinking, very few problems are to be expected with Disulfiram treatment. All effective drugs will cause some side effects in some people, but as drugs go, Disulfiram is probably rather less dangerous that aspirin. The most serious side effect is the reaction with alcohol, but that is why we prescribe it. Very occasionally, the reaction can be fatal, but continued heavy drinking is much more dangerous. As for Naltrexone, I am providing you information here. The implant is done only at my center in Delhi. I would like to add here that Naltrexone is much more effective with Opiates than with Alcohol. NALTREXONE IMPLANTS - AN INTRODUCTION Naltrexone is a narcotic antagonist. It works by blocking the opioid receptors in the brain and therefore blocking the effects of heroin and other opioids. Those who take it know that they cannotachieve a high from using heroin / alcohol and that any money therefore spent on heroin / alcohol will be wasted. It does not directly stop a person wanting to use heroin / alcohol, although it may reduce or prevent cravings in some people. We now offer a Naltrexone implant, which appears to give effective blood levels for eight weeks on an average. It is usually inserted under local anaesthetic after detoxification is over and 2 - 3 doses of the oral Naltrexone have been given. It is inserted through a 1 cm incision in the lower abdomen or at the back of the upper arm. The implant is inserted 3-4mm under the skin. ADVANTAGES OF IMPLANTS · Makes relapse almost impossible while the implant is effective · Avoids the need to supervise Naltrexone and the arguments it can cause. · Makes it impossible to forget to take Naltrexone · Probably reduces craving even more than oral Naltrexone because there is no point in craving for what you cant have. DISADVANTAGES OF IMPLANTS · Involves (minor) surgery and a small scar with temporary tenderness and bruising · Occasional local infection or inflammation of implant site, usually responding to antibiotics. · Initially more expensive than oral Naltrexone. · Risk of turning to non-opiate drugs - including alcohol - as a substitute. (Applies as much to oral Naltrexone) It must be emphasised that the need for aftercare counselling to allow thorough social integration is not reduced when implants replace oral Naltrexone. Aftercare counselling is essential to ensure that healthy and appropriate coping behaviours are learnt, rather than substituting other drugs for heroin and methadone.