What does the Esperal implant procedure look like?

Esperal, the so-called alcohol implant, is a preparation implanted under the skin that is meant to discourage alcohol consumption. The active substance (disulfiram) disrupts alcohol metabolism in the body, which means that after drinking even a small amount, violent, very unpleasant symptoms resembling poisoning may appear. For many people, this is a strong "brake" before returning to drinking and interrupting binge drinking. Almost everyone who has encountered the addiction problem has heard about the implant, but the name itself often raises more questions than answers. Therefore, we explain what the Esperal implantation procedure involves and what disulfiram treatment entails.

Qualification for the Esperal implant procedure and contraindications

At Nasz Gabinet, qualification is a standard because we treat patient safety as an absolute priority. Our doctors assess whether there are factors that could increase the risk of side effects or complications after the procedure. During the consultation, a detailed medical history is taken. The doctor asks, among other things, about chronic diseases, past surgeries and procedures, regular medications, supplements, and allergies. The patient's previous experiences with disulfiram (if it was used) are also important. Based on this, the specialist assesses whether Esperal implantation is possible and advisable in the given case. Contraindications to Esperal implantation include:

• severe heart and cardiovascular diseases,

• liver or kidney failure,

• selected mental disorders,

• epilepsy,

• pregnancy and breastfeeding,

• allergy to the active substance.

Preparation for Esperal implantation – what should the patient know

Proper preparation for Esperal implantation is very important for the patient's safety and comfort. The alcohol implant works in a way that causes a violent reaction of the body after contact with alcohol, so abstinence is necessary before the procedure. The doctor assesses whether the patient is sober and whether there is a risk of a reaction occurring already at the qualification stage or during the procedure. In practice, this means that before implantation, it is necessary to abstain from alcohol for the minimum time indicated by the doctor, tailored to the clinical situation and health condition. Before the procedure, the patient should thoroughly inform the doctor about all medications and supplements being taken, including over-the-counter ones. This particularly applies to preparations containing alcohol, such as some herbal drops, syrups, or warming agents. In the medical history, chronic diseases, seizure episodes, previous neurological injuries, and any situation that may affect the safety of the Esperal implantation procedure are also important. An important element of preparation is avoiding alcohol in any form. The patient may not be aware that small amounts are present in mouthwashes, syrups, throat sprays, and sometimes also in cosmetics and disinfectants. Therefore, before an alcohol implant, it is worth checking compositions and discussing with the doctor which products may pose a risk.

Esperal implantation procedure step by step – how it works in practice

The Esperal implantation procedure is a short procedure performed under local anesthesia. It involves placing tablets under the skin so that the active substance is released gradually and supports maintaining abstinence. At Nasz Gabinet, the procedure is outpatient, so the patient does not require hospitalization. Course of the alcohol implant procedure step by step:

1. Consultation and selection of procedure site: most often the gluteal or scapular area, because these are safe places, less exposed to irritation and conducive to healing; the location is chosen by the doctor, taking into account, among other things, body structure, patient activity, and any scars.

1. Administration of local anesthesia: The patient may feel a short prick and burning during the administration of anesthesia; during Esperal implantation, they should not feel pain, only pressure, touch, or gentle "pulling" of tissues is possible.

1. Skin incision and tablet placement: The doctor makes a small incision and prepares the subcutaneous site for tablet placement. They are introduced subcutaneously in a way that ensures stable positioning of the preparation.

1. Stitching and bandaging: The wound is closed with stitches and secured with a bandage.

1. Recommendations and follow-up: The patient receives instructions on wound care, activity restrictions, and safety rules (including absolute avoidance of alcohol); a date for possible follow-up and stitch removal is also set, if necessary.

It is worth remembering that the Esperal implantation procedure is support in maintaining abstinence, but does not replace treatment of the causes of addiction. The best results are achieved by combining the alcohol implant with therapy and professional support, which helps the patient consolidate the change and reduce the risk of relapse.

How long does the Esperal implantation procedure take

How long the Esperal implantation procedure takes depends on the patient's individual situation, but the procedure itself is usually short and takes up to 30 minutes. Most of the time during the visit is not taken by the actual alcohol implant implantation, but by preparation: discussion of the preparation's action, safety, contraindications, and recommendations after the procedure. In practice, the visit includes several stages:

• brief assessment of the patient's condition on the day of the procedure and confirmation of qualification

• preparation of the surgical field and administration of local anesthesia

• performing a small incision and placing tablets under the skin

• stitching, bandaging, and providing recommendations

• brief observation after the procedure to ensure the patient feels well

The total visit time can be influenced by, among other things, body structure, previous scars in the area of the planned incision, individual reaction to anesthesia, or the need for more detailed discussion of recommendations. At Nasz Gabinet, the Esperal implantation procedure is performed on an outpatient basis, so after completing the procedure and receiving instructions, the patient can return home the same day.

Is Esperal implantation painful and what does wound healing look like

Many patients before the procedure are concerned that Esperal implantation will be painful. In practice, the alcohol implant procedure is performed under local anesthesia, so pain is not felt during the procedure. Most often, only a slight prick and burning appear at the moment of anesthesia administration. After the implantation procedure, temporary discomfort in the incision area is possible. In some patients, tenderness, slight swelling, bruising, or a feeling of skin tension occur, especially when sitting, bending, or during more dynamic movements. These are typical healing symptoms and usually gradually subside. Wound healing after an alcohol implant usually proceeds without complications, provided the patient follows the recommendations.

Recommendations after Esperal implantation – what to avoid?

Recommendations after Esperal implantation have one main goal: to ensure patient safety and reduce the risk of complications, while supporting the maintenance of abstinence. The most important rule is complete avoidance of alcohol, but recommendations regarding wound healing and daily activity are also important. After Esperal implantation, the patient should avoid:

• alcohol in any form: alcoholic beverages, as well as non-alcoholic beer, if it may contain trace amounts of ethanol

• "hidden" alcohol in everyday products, including some syrups, drops, mouthwashes, throat sprays, herbal tinctures, spirit preparations, and selected cosmetics and disinfectants

• intensive physical exertion in the first days after the procedure: strength training, running, contact sports, and activities causing skin stretching in the suture area

• prolonged soaking of the wound: bathing in a bathtub, swimming pool, jacuzzi, and using a sauna until the wound is properly healed according to recommendations

• touching, scratching, or checking the wound: peeling off the bandage unnecessarily and pressing the procedure site, which may increase the risk of irritation or infection

For many patients, an important element of recommendations after the implant is also a plan for risk situations: stress, social gatherings, peer pressure, or alcohol cravings. Esperal can be strong support in maintaining abstinence, but it gives the best results when the patient simultaneously uses therapy and professional help. At Nasz Gabinet, we help select further steps so that the implant is the beginning of real change, not just a safeguard.

Possible complications after an alcohol implant and when to see a doctor

It is worth visiting a doctor for a check-up when symptoms such as these appear:

• increasing, severe pain at the procedure site or pain that does not subside from day to day

• pronounced redness, skin warming, rapidly growing swelling

• wound discharge, suppuration, unpleasant smell of the bandage

• fever, chills, general deterioration of condition

• wound dehiscence or bleeding that cannot be controlled by pressure

• symptoms of an allergic reaction: generalized rash, itching, swelling, shortness of breath

• severe discomfort after alcohol contact or suspicion of a disulfiram reaction

After the procedure at our facility, the patient receives clear instructions on how to observe the wound and when contact with a doctor is necessary. A quick consultation in case of doubt is the simplest way to ensure safety and a calm course of convalescence.

Support in addiction treatment at Nasz Gabinet – what comes after the implant?

An alcohol implant can effectively support abstinence, but does not remove the causes of addiction. Therefore, after Esperal implantation, it is worth immediately planning further steps that will help maintain the change and reduce the risk of relapse. Most often, this means starting therapy, during which the patient learns to recognize drinking triggers, cope with alcohol cravings and stress, and build new action strategies in difficult situations. At Nasz Gabinet, support is provided on an outpatient basis, and we tailor the help plan to the patient's real situation. If you want the implant to be the beginning of lasting change, contact us. We will help select the next stages of treatment and safely go through the recovery process.

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