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=== Guidelines for treatment of Alcohol-use disorder ===
An alcohol use disorder is a highly prevalent and disabling condition. It is associated with high rates of medical and psychiatric comorbidity as well as early mortality. The psychiatric diagnoses, alcohol abuse and alcohol dependence has been labelled as alcohol use disorder, in DSM-5.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines "at risk" drinking (which suggests that the person is at risk for adverse consequences):
*Greater than 14 drinks per week or 4 drinks per occasion for healthy men under age 65.
*Greater than 7 drinks per week or 3 drinks per occasion for non-pregnant, healthy women under age 65 and healthy men over age 65.
A standard drink contains approximately 0.5 ounces (~30 ml) of alcohol as defined by Department of Health and Human Services and the United States Department of Agriculture. This corresponds to 12 fluid ounce of regular beer, 5 fluid ounce of wine, and 1.5 fluid ounce of 80-proof distilled spirit.
Criteria for at-risk drinking may be modified by comorbidities, especially in the older population. Increased mortality risk has been demonstrated for older patients who are at-risk drinkers, as defined by the CARET (Comorbidity-Alcohol Risk Evaluation Tool). Any drinking can be considered “at-risk” for pregnant women, for those who take medications that interact with alcohol, or for those with a health condition that can be caused or exacerbated by alcohol (eg, hepatitis C)[15].
=== Principles of non-pharmacological treatment in Madatyayaya & Satvavajaya ===
In madatyayaya the effects of Madya usually have been observed at physical as well as psychological levels. To treat the ill-effects of alcohol physician has to address Psychological aspects on personal. Familial & social level by various settings of counseling with the patient. As per the concept of mind in Ayurveda, Rajas & Tamas are the Dosha, the pathologies related to the mind or psyche and the imbalances in these two doshas lead to simple psychological disorders to complex psychiatric diseases. Satva, on the other hand is the quality of mind, which if dominated, can control the two Raja & Tama. Therefore, Satvavajaya is one of the treatments for Madatyayaya; where controlling of Dharaneeya vega (Urges to be controlled) is recommended to achieve balance in Raja & Tamo guna; which eventually can achieve the balance of mind in Alcohol withdrawal phase.
=== Conventional aspects of non-pharmacological treatments ===
Short-term goals of treatment include:
*Encouraging abstinence or reduction of alcohol use
*Promoting participation in counseling programs and mutual help groups
*Increasing pleasant, sober activities
*Involving family, community, and employment resources, including Employee Assistance Programs
Long-term goals include:
*Restoration of self-esteem
*Resolution of alcohol-related social problems
*Improvement in physical health
*Lasting abstinence from alcohol use
Research studies suggest that a small but significant proportion of patients may be able to resume normal or controlled drinking. Controlled drinking is probably more likely for people with a mild disorder (or at-risk drinking) and not for a more severe disorder. Advocates for a “harm reduction” approach as an alternative to abstinence may acknowledge that abstinence is the best outcome, but that not every individual achieves this end, and that controlled drinking for some individuals is an achievable aim which reduces risk to patients.
=== Principles of pharmacological management in Madatyayaya ===
The qualities of “Oja” are mentioned in this same chapter where the elaboration of ''madya'' has been done. The reasoning behind this if tried to understand with [[Tantrayukti]] suggests that since the ''Oja'' & ''Madya'' are opposite in qualities; the treatment of ''Madatyayaya'' should be done on the guidelines of ''Ojo-vardhana''.
The ''Madhura rasa'' among the six tastes has been identified as the one which enhances the Oja and maintains it, as described in Chapter 26th of sutrastahana (Cha. Su. 26/42(1)). Caraka further in consecutive chapter 27th, mentioned all 12 classes of Dietary components where Madhura rasa dravyas of each class has been mentioned including the plant derived as well as animal derived products.
The medicinal plants of pharmacological importance with madhura rasa & vipaka shall be preferred for treatment of Madatyaya, as per the principle, where the treatment with Viruddha Guna has been advised.
=== Concept of Santarpana & Alcohol related Malnutrition ===
Alcohol, if consumed in excess, can cause malnutrition which can lead to nutritional disorders as well as organ damage. The initial phase nutritional imbalances particularly depletion can be very well controlled with the concept of Santarpana, as described by Charaka (Cha.Su. 23/31-38). Various pharmacological, dietary products have been discussed here along with use of liquor prepared from Grain for Santarpana. This principle later used in this chapter 24th, where in some cases treatment of Madatyayaya with Madya itself has been described.
=== Index 2 ===
=== Index 2 ===