Alcohol is the most commonly abused drug in the United States. Alcohol can form an intense physical dependence for individuals that drink heavily on a regular basis. When they stop drinking, a severe withdrawal can occur.
In mild cases, alcohol withdrawal symptoms may be only uncomfortable. The individual could experience minor symptoms such as shaking or sweating. The most serious withdrawal problem from alcohol is when a person has delirium tremens (DT’s). Individuals can die from a seizure from having delirium tremens so it should never be taken lightly.
A professional medical detoxification in an inpatient treatment setting manages these concerns safely, by aid of various medications. Benzodiazepines and anticonvulsants are most commonly used for this purpose.
Why Does Alcohol Withdrawal Occur?
Like other drugs, the moment you begin using alcohol it goes to work changing the way your brain functions. As use becomes more frequent and intense, these changes become more severe and lasting. One of the largest impacts is felt within our neurotransmitters, specifically one called GABA. These important brain chemicals are responsible for regulating critical functions within our bodies, including the autonomic nervous system, cognition, and mood.
In the presence of a constant influx of alcohol, as within an addicted state, your brain drastically cuts back on its own production of neurotransmitters. This reliance is termed a physical dependency. Should a person stop using alcohol, or radically reduce their consumption, their body experiences an intense state of shock called withdrawal.
When you drink alcohol, it increases GABA’s effects, which reduces the amount of excitability within your brain, as explained by the American Family Physician (AFP). During withdrawal, without alcohol, your brain becomes excessively excited, which leads the sense of unease and edginess which accompanies withdrawal.
What Are The Signs Of Alcohol Withdrawal?
After the last drink, symptoms of withdrawal may occur in as little as a few hours, or it may take up to several days for certain individuals to encounter these effects. The severity of withdrawal is influenced by:
- How long a person has been drinking for.
- The amounts regularly consumed.
Withdrawal from alcohol can cause:
- Anxiety
- Brain fog
- Confusion
- Cravings
- Depression
- Insomnia
- Nausea and vomiting
- Rapid heart rate
- Sweating
- Tremors or shaking
For long-term, heavy drinkers, withdrawal can become severe. Drinkers of this sort are far more common to experience delirium tremens (DT’s), a severe and dangerous form of withdrawal. According to MedLinePlus, symptoms typically begin two to four days after a person stops drinking, but in certain cases they may not occur until day seven or ten. This state is marked by:
- Agitation
- Extreme confusion
- Fever
- Hallucinations
- Mood swings
- Seizures
- Stupor
The risk of withdrawal-induced fatality is heavily increased by DT’s. The AFP warns that one to five percent of individuals who progress to these states experience fatality. This reality strongly increases the need for a specialized medical detox for certain individuals.
Is Detox A Necessary Part Of A Treatment Program?
Detoxing from alcohol at home or anywhere other than under medical care is never recommended. Doing so can be very dangerous and life-threatening. for most individuals, alcohol addiction treatment is best begun by a medical detox.
During unmonitored withdrawal symptoms and cravings can become extreme and debilitating. Many people retreat back to substance abuse to stop these effects. Medications can be a life-saving tool during this time.
Medications Used To Manage Alcohol Withdrawal In A Detox Setting
The primary aim of pharmacotherapies (medications used within treatment) during detox is to stabilize and begin to normalize a person’s brain chemistry. Detox seeks to make withdrawal as comfortable and painless as possible. While some medications address physical concerns such as nausea and shaking, work to address issues which trouble a person on emotional and mental levels.
Using Benzodiazepines During An Alcohol Detoxification
Anxiety and agitation can run high during withdrawal. During this time a person may also be fearful of their future, as they’re intimidated by the prospect of living a life without alcohol as a form of self-medication.
To counter these and other states, benzodiazepine medications may be used, either as needed, or on a fixed-schedule regimen. These medications have a sedative and calming effect, which can be of great benefit during this time.
The following benzodiazepines are frequently used for these purposes:
- Chlordiazepoxide (Librium)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Oxazepam (Serax)
They also note that within “a fixed-schedule regimen, doses of a benzodiazepine are administered at specific intervals, and additional doses of the medication are given as needed based on the severity of the withdrawal symptoms.”
Benzodiazepines widely impact the functioning of your central nervous system (CNS), as does alcohol. This is yet another reason why you should never detox on your own. Should you attempt this on your own, and be taking these medications while you relapse, the CNS depression could lead to overdose and death.
Other Medications Are Used To Treat Alcohol Withdrawal
The following medications may also be used to treat alcohol withdrawal:
- Atenolol (Tenormin)
- Carbamazepine (Tegretol)*
- Clonidine (Catapres)
- Gabapentin (Neurontin)*
- Haloperidol (Haldol)
- Oxcarbazepine (Trileptal)*
- Valproic acid (Depakene)*
Anticonvulsants are also widely used during this time (these are marked above by an asterisk). They do caution that in most cases these medications should not be used as “monotherapies,” or medications used as standalone treatments.
The National Institute on Drug Abuse asserts that Acamprosate (Campral) works on GABA, and “is thought to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria.” They also note that topiramate is believed to impact GABA, and for this reason may be used off-label as a treatment.
Individuals with other medical conditions may require special considerations when using medications. For example, the AFP suggests that phenytoin (Dilantin) may help individuals already prone to seizures, whereas individuals diagnosed with coronary artery disease may benefit from beta blockers.
The toll of withdrawal is further compounded by the way alcohol abuse depletes your body of vital hydration, nutrients, and vitamins, leaving you malnourished and dehydrated. Intravenous (IV) hydration may be used to boost a person’s fluids and electrolytes. Multivitamins and B vitamins (especially thiamine) may be administered to balance any malnourishment caused from abuse.
Detox Safely From Alcohol Today
If you’re considering treatment for an alcohol addiction, contact DrugRehab.org today. We will find the right program that fits both your needs as well as your budget. All calls are 100 percent confidential.
For More Information Related to “Medications To Manage Alcohol Withdrawal” Be Sure To Check Out These Additional Resources From DrugRehab.org:
- The Dangers of Mixing Alcohol with Valium (Diazepam)
- What is “Wet Brain”?
- Is Alcoholism Genetic or Hereditary?
- How Common is Alcohol Abuse?
- Klonopin Withdrawal Symptoms
Sources
American Family Physician — Outpatient Management of Alcohol Withdrawal Syndrome
MedlinePlus — Alcohol Withdrawal
National Institute on Alcohol Abuse and Alcoholism — Complications of Alcohol Withdrawal
National Institute on Alcohol Abuse and Alcoholism — Alcohol Dependence, Withdrawal, and Relapse
