Alcohol withdrawal syndrome refers to a group of symptoms that a person experiences when he/she abruptly stops drinking alcohol after binge drinking on a regular basis for over years. This happens because the body becomes dependent on the frequent drinking patterns. After the sudden change in habit it takes time for the body to acclimatise without the chemicals that it had been used to for so long. Alcohol withdrawal syndrome can have mild to severe effects and can be life threatening too.
The reasons of alcohol withdrawal syndrome can be many. While drinking the compounds in it that are easily metabolised by the liver are excreted with the urine but those that cannot get metabolised, get absorbed by other parts of the body, especially the brain. These non-metabolised compounds have an inhibitory effect on the neurotransmitters released by the neurons in the brain.
This inhibitory effect on neurotransmitters causes a person to feel easy post drinking also making speech slurred, walking and co-ordinating difficult and memory to lapse. So, on quitting alcohol consumption, the neurotransmitters do not get any inhibitory effect on the brain, thereby causing hyper excitability.
Due to this the person gets affected by the symptoms that start about 6 hours after drinking the last alcohol. Within 24 to 48 hours the symptoms are at their peak. The common symptoms are feeling uncomfortable, sweating, fluctuating blood pressure, tremors, anxiety, nausea and vomiting, insomnia, auditory, visual and tactile hallucinations and seizures etc.
some people may also experience post-acute withdrawal symptoms after the initial symptoms. These post-acute withdrawal symptoms (PAWS) are prolonged side effects that may last for several months. Due to PAWS the person can feel dizzy, anxious, fatigued, loss in memory, delayed reflexes, have emotional outbursts, sleeping problems etc.
There are treatment options for alcohol withdrawal syndrome like medication, rehab facilities and support group that may also include family and closed ones. Treatments include detoxification, behavioural modification and counselling.
When a person quits drinking the withdrawal symptoms are bound to affect. Treatment options available are quite helpful in getting out of the condition. So, the treatment aims at reducing the withdrawal symptoms, preventing the complications that arise due to use of alcohol and to help the person abstain from alcohol in future.
Therapies involve inpatient treatment, outpatient treatment, medication, individual counselling and support groups. In inpatient treatment patients are provided 24-hour intensive care to help come out of the struggle after quitting alcohol. The treatment is given in a hospital and includes regular monitoring of body temperature, blood pressure, heart rate and also level of different chemicals in the blood that are affected by alcohol intake.
Administering intravenous fluids and medicines and sedating the patient with medicines till the symptoms go away. Outpatient treatment is mainly for patients with mild to moderate symptoms. The treatment is usually given under continuous supervision of someone and paying regular visit to your therapist.
In outpatient treatment patient is treated with sedatives, counselling of patient as well as his/her family, monitoring of chemicals in the blood with blood tests as recommended by the therapist and also treatment for other medical conditions associated with excessive alcoholism. Treatment with medications is done to relieve uncomfortable symptoms.
Drugs used for treating alcohol withdrawal syndrome are benzodiazepines, vitamins, anticonvulsants and a few others like clonidine in combination with benzodiazepines, haloperidol like antipsychotics along with benzodiazepines for treating agitation and psychosis. There are also medications that help abstaining from alcohol like acamprosate, disulfiram and naltrexone. Benzodiazepines are quite effective and safe in preventing seizures or fits. The commonly used benzodiazepines are diazepam and chlordiazepoxide.
People with liver problems may be treated safely with benzodiazepines like lorazepam. It is important to administer some vitamins like thiamine, folic acid and pyridoxine in patients with alcohol withdrawal syndrome because they usually become deficient in vitamins and nutrients. This multivitamin administration is done intravenous. The symptoms may also cause convulsions in the patient which can be treated with anticonvulsants like pregabalin and topiramate, paraldehyde in combination with chloral hydrate. The patients can also be counselled individually and also along with their family members by therapists.
Any person experiencing the symptoms of alcohol withdrawal like discomfort, irritability, insomnia, nausea, vomiting, mood changes etc. are eligible for the treatment.
People who do not binge drink and stop drinking completely at any point will not experience alcohol withdrawal symptoms and hence, they will not be eligible for treatment.
Side effect of benzodiazepines is addiction to the drug during an attempt to remove addiction of alcohol. Patient can become benzodiazepine dependent. Sometimes the mental effects due to alcohol may go untreated with benzodiazepines. Benzodiazepines along with alcohol can have adverse psychological impacts like developing depressive moods.
Some common side effects of chlordiazepoxide are dizziness, fatigue, selling, headache, skin rash, irregular menses, etc. It is important that the patient informs the doctor if some serious side effects like depression, hallucinations, muscle twitching, jaundice, hyperactivity, abnormal sleeping patterns, trouble urinating etc.
Post treatment guidelines for alcohol withdrawal can be preference to stay in a quiet place, in the presence of soft lights, in limited contact of people, living and choosing a positive and supportive environment and having lots of healthy fluids and foods.
For some people who try hard to become sober and abstain from alcoholism in their first attempt easily recover with a few weeks or may be in a month or two. But people who have more dependence on alcohol and cannot try to leave it easily take more time like over years to over alcoholism.
The price of treatment for alcohol withdrawal syndrome may range from Rs. 500 to Rs. 5,000 depending on the time required by each patient to recover.
Yes the results are usually permanent.
There are a few effective alternatives to alcohol withdrawal treatment like practicing meditation that helps you maintain focus for some time and have positive thoughts in the mind. Acupuncture can also be used for treating the life threatening syndrome. Yoga, light therapy especially soft lights, some herbs like kudzu, a Chinese weed has been prove to reduce alcoholism in addicts.