Addiction Disorders and Therapy

Therapeutic Apheresis in Alcohol Dependence Treatment

*Valerii A Voinov
Therapeutic Apheresis Department, I.P.Pavlov First Saint-Petersburg State Medical University, Russian Federation

*Corresponding Author:
Valerii A Voinov
Therapeutic Apheresis Department, I.P.Pavlov First Saint-Petersburg State Medical University, Russian Federation
Email:voinof@mail.ru

Published on: 2019-07-24

Abstract

Alcoholism, being widely spread, is not only a serious medical but also social issue. Alcoholic hepatitis and cirrhosis are severe complications of alcoholism. Continued alcohol intake during pregnancy causes serious complications in the fetus. Withdrawal syndrome and delirium develop when trying to cease alcohol intake, which frequently leads to lethal outcome. All of these complications are based on severe intoxication that cannot be stopped only with help of drug therapy, which requires extracorporeal detoxification, mainly plasma exchange and hemosorption.

Keywords

Alcohol dependence; alcoholic hepatitis; liver cirrhosis; abstinence syndrome; delirium; intoxication; extracorporeal detoxification; plasmapheresis; hemosorption

Introduction

Alcoholism in recent years becomes more widespread in various countries all around the world. At least one of four patients in the US intensive care units has problems with alcohol [1], and the cost of treating them exceeds $ 5,000 [2].
It is believed that the daily intake of alcohol (in terms of absolute alcohol) 20-60 g for men and 10-40 g for women are relatively safe, but the true body need for alcohols does not exceed 10 g per day and it is completely covered by endogenous alcohols.
However, exceeding this level increases the risk of toxic lesions, especially when an individual is deficient in the level of enzyme alcohol dehydrogenase, which destroys alcohol. With an excess of alcohol, catalase and monooxygenase oxidation is activated with activation of lipid peroxidation and acetaldehyde hyper production, and if there is a deficiency in acetaldehyde dehydrogenase (the enzyme that destroys the latter), acute or chronic alcohol intoxication develops. At the same time, there is an irresistible craving for alcohol, which becomes constant and addictive [3].