Symptoms of Alcohol Withdrawal
As with other drugs, the severity of alcohol withdrawal varies from individual to individual, the longer someone abuses alcohol, the worse the withdrawal.
Physically dependent alcoholism may take years to develop. Unlike cocaine or nicotine addiction (which may take only a few months to develop), the person may drink for ten to fifteen years before becoming an alcoholic.
After such a long time, alcohol—and the addiction—has been woven deeply into the fabric of the person’s life.
And compared to the illegal drugs, alcohol in one way or another has probably been associated with a wider variety of activities: weddings, family dinners, birthday parties, football games, holidays—celebrations of all kinds—have become associated with drinking. It is not an easy pattern to break. The lengthy time period and ingrained associations of alcoholism increase the difficulty of withdrawal, and no one with a severe drinking problem should try to quit on his own.
Hospitals and inpatient rehabilitation detoxification provides the needed medical attention, including fluids, vitamins, rest, sedation to ease the symptoms, and sometimes other medications to control the potential toxic effects of withdrawal, such as delirium tremens (DTs). DTs is a form of alcoholic psychosis characterized by extreme anxiety, trembling, sweating, upset stomach, and chest pain. Another more frequent need for residential rehabilitation detoxification is the possibility of having a potentially fatal grand mal seizure on day three of alcohol detoxification. This is another vital reason why alcohol detoxification is not for do-it-yourselfers.
Alcohol, and benzodiazepine, withdrawal and detoxification are the two most potentially lethal withdrawals of all drugs including oxycodone, fentanyl and carfentanil.
Medical alcohol detoxification is started when the signs and symptoms of alcohol withdrawal begin to peak, usually within hours of the last drink.
A benzodiazepine kind to the liver (Librium, generic name chlordiazepoxide) is used by some rehabs because by the time Librium is needed, the person’s liver is very much damaged. Librium is kindest to the liver when compared to other benzodiazepines.
The good news is patients can measure how well their body is detoxifying not only by noticing a gradual improvement in attitude and mood, but also by watching their liver enzyme numbers going down. Remember, two beers daily for one week can show measurable liver changes.
Alcohol Withdrawal Symptoms
Although DTs and seizures are the most dangerous symptoms of alcohol withdrawal, the most usual and customary symptoms are the same as nicotine withdrawal, opioid withdrawal, benzodiazepine withdrawal, and anxiety disorders:
- Excessive worry
- Feeling agitated
- Difficulty concentrating
- Tense muscles
- Trouble falling or staying asleep
- Panic, anger, or hate attacks
- Avoiding social situations
- Irrational fears
- Attention deficit & confusion
However historically significant, Librium is rarely used today. This is because the first IOP (developed by one of our associates in 1985) had concerns about Librium for alcohol withdrawal:
- Librium, like all benzodiazepines, are addictive drugs that are associated with a long life of misery, grand mal seizures and death, just like alcohol.
- Librium used during alcohol withdrawal sends the addiction-replacement-message that it’s okay to substitute alcohol with “alcohol” in a pill.
- Non-addictive medicines should be used whenever possible, in place of addictive ones (i.e. clonidine & pregabalin in place of buprenorphine in opioid dependence.
- Pregabalin and its relatives are a better option because they:
- are not addictive;
- end the likelihood of a grand mal seizure;
- decrease worry & increase relief;
- decrease agitation & increase calm;
- decrease restlessness & increase tranquility;
- decrease fatigue & increase energy;
- increase concentration;
- decrease irritability & increase serenity;
- decrease muscle tension & increase comfort;
- decrease insomnia & increase somnolence;
- decrease panic, anger, or hate attacks & increase acceptance & acts of compassion;
- increase socialization;
- decrease irrational fear & increase sustained endurance;
- & decrease attention deficit & confusion & increase focus and conceptualization.
Different medications are used to assist recovering alcoholics during aftercare including:
Occasionally, the prescription medication Antabuse (generic name disulfiram) may be used for brief periods to help patients through the withdrawal.
Like other medication-assisted detox and rehabilitation facilitators, Antabuse should only be used to help patients maintain sobriety while receiving other forms of supportive and psychological treatment.
When indicted, naltrexone can help a thought of drinking become a drink-in-hand by making the recovering alcohol stop and think: My opioid receptors are blocked because I took naltrexone this morning. So, if I have that drink it won’t relax me because my alcohol/opioid receptors are blocked. Why bother having that drink. Instead, I’ll do some positive imagery to relax.
Regardless, addicts often see naloxone’s loophole. Loophole?
Yup, and here is how it sounds: I feel like drinking. So what I will do is not take my naltrexone for a couple of days and then drink or if my wife makes me take it I’ll drink three times as much and see if it breaks through the opioid-blockade.
Medication-assisted detox and rehabilitation prescription without other forms of recovery-sensitive supportive therapy treatment is flirting with death.
Medication assisted detoxification with a detox-dispensed medicine is a must with alcohol dependence.
Medication assistance without an alcohol dependence recovery therapy program is a grave disservice.
Medical detoxification with a concurrent alcohol dependence recovery therapy program is your ticket to ride sustained-recovery, as long as you leave the driving to the pros.
“Success is the sum of small efforts, repeated day in and day out”
– Robert Collier
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