Alcoholism is a serious problem that affects millions of Americans from all walks of life. From occasional binge drinking to severe physical addiction, alcoholism is a broad condition that often requires extensive treatment. Alcohol withdrawal is the result of physical dependence, with specific and potentially dangerous symptoms often experienced when alcohol use is discontinued. Alcohol withdrawal can be successfully treated through detox and treatment, with medications often used to alleviate symptoms and reduce the possibility of relapse.
Alcohol withdrawal refers to the physiological process that takes place when alcohol intake is stopped. The alcohol withdrawal syndrome is a set of symptoms that occurs shortly after cessation of use, due largely to a hyper-excitable response of the central nervous system. The length and scope of symptoms depends on the extent of alcohol dependence, with the withdrawal syndrome typically progressing through a number of stages. Alcohol dependence and associated withdrawal is largely due to alcohol-induced neuro-adaptation, with the body and brain slowly becoming dependent on alcohol over time.
Alcohol withdrawal symptoms mostly take place in the central nervous system, with symptoms experienced almost immediately and dissipating slowly over a period of days to weeks. While a protracted withdrawal syndrome is possible in some cases, most alcoholics will be clean and ready to start further treatment within one to six weeks. Typical early symptoms start 6-12 hours after the last drink, including shaking, headaches, vomiting, nausea, anxiety and sweating. If symptoms continue after this period, they are likely to include mental confusion, hallucinations, tremors and agitation. At 24-48 hours after alcohol discontinuation, the possibility of seizures should be expected. A protracted withdrawal phase may be experienced in severe cases of alcoholism, with depression, anhedonia, disorientation, nausea, vomiting and headaches all likely.
A variety of medications are used to treat alcohol withdrawal, with doctors analyzing each case for possible cross-tolerant drug relationships and mental health disorders. Benzodiazepines are commonly used to suppress symptoms and manage the withdrawal process, with drugs like Valium and Serax used in many detox centers. Naltrexone may be used in certain cases, with anticonvulsants like topiramate and carbamazepine and the NMDA antagonist acamprosate also useful. Medication plays an important role in alcohol detoxification, with residential treatment recommended so that patients can access prescriptions and medical support at all times. Alcohol detox does not address the precedents of abuse and dependence, with ongoing behavioral therapy and relapse prevention programs initiated once detox has been completed.
A range of benzodiazepine drugs are used to treat alcoholism, with Librium, Valium, Ativan and Serax the most widely prescribed medications. There are several treatment regimes that use benzodiazepine drugs, with some patterns administering drugs periodically over a period of days and others deferring treatment until symptoms occur. The type of drugs prescribed depends on the pattern of treatment, with short-acting benzodiazepines used in some cases and long-acting drugs used in others. Librium is the benzodiazepine of choice in the majority of uncomplicated alcohol withdrawal cases, with its long half-life enabling gradual dosage reduction. Valium is often used intravenously by patients who are unable to take medications by mouth, with Ativan used to treat patients with a history of liver failure. Once a medication regime has been completed, patients will often enroll in a drug treatment program to treat the underlying causes of alcoholism.