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What is Alcohol Withdrawal (Detox)?

Alcohol withdrawal refers to the symptoms that develop in the body after a long-term heavy alcohol user stops drinking. Withdrawal occurs because the body is dependent on alcohol. And, once alcohol is no longer present in the body, it has to adjust. The body and brain have to figure out how to function without it.

Alcohol withdrawal and detox is a dangerous process that requires medical supervision. It should occur in a medically supportive environment that provides both physical and emotional support.

Common Alcohol Withdrawal Symptoms

Withdrawal symptoms vary from person to person. They are also based on the severity of alcohol use and the level of alcohol dependence. Side effects and symptoms of alcohol withdrawal include:

  • Elevated blood pressure
  • Clammy skin
  • Headache
  • Insomnia
  • Nausea
  • Vomiting
  • Rapid heartbeat
  • Tremors
  • Sweating
  • Shakiness
  • Loss of appetite
  • Withdrawal seizures

There are also psychological symptoms, including:

  • Anxiety
  • Depression
  • Nightmares
  • Difficulty focusing or thinking clearly
  • Fatigue
  • Irritability
  • Rapid emotional fluctuations

In severe cases of alcohol withdrawal, people experience a condition called delirium tremens (DTs). DTs arise between two and four days after a person’s last drink. The condition is more likely to occur if someone with alcohol use disorder is also malnourished when they get sober.

Symptoms of DTs include:

  • Agitation
  • Confusion or disorientation
  • Fever
  • Excessive sweating
  • Blood pressure fluctuations
  • Hallucinations
  • Irregular heartbeat
  • Seizures
  • Tremors
  • Sensitivity to light, sound, and touch

DTs can progress quickly and are potentially life-threatening. The condition requires immediate medical attention.

The most severe alcohol withdrawal symptoms occur in people who are long-term heavy drinkers. Detoxing from alcohol is a smart choice, but it is risky. The process requires medical attention, monitoring of vital signs, and treatment for severe withdrawal symptoms. Treatment programs also provide supportive care that increases the chances for a full recovery.

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How to Safely Withdraw from Alcohol

It is possible to safely withdraw from alcohol in a professional healthcare environment. Proper management of alcohol withdrawal reduces or eliminates many of the symptoms of alcohol withdrawal. It also increases the chances of successful long-term recovery.

Mild to moderate withdrawal is possible in an outpatient setting, but it still requires medical attention. Most outpatient programs require daily medical check-ins. People with severe addictions and long-term alcohol consumption are safest in inpatient programs with round-the-clock medical attention.

If you or a loved one is ready to get sober after long-term alcohol use, contact a doctor. A medical assessment helps you determine whether it is safe to withdraw using an outpatient program. A doctor can also explain the complications that can occur during withdrawal and help you decide when to seek emergency medical attention during an outpatient withdrawal.

What is Medication-Assisted Treatment (MAT)?

Medication-assisted treatment (MAT) is a safe and effective approach to withdrawal and recovery. It utilizes pharmaceuticals in combination with behavioral therapy and counseling. MAT uses FDA-approved medications to ease the symptoms of withdrawal and reduce cravings for alcohol or drugs. It also reduces the risk of overdose.

Programs that use MAT are customized to meet the needs of each patient. 

Researchers believe that MAT, when used properly and in combination with other types of therapy, is a successful treatment approach for many people. 

MAT is most often used to treat heroin and prescription pain relief medication, but it is also used to treat alcohol addiction. Medications help the brain return to normal function, block the feel-good effects of drugs, reduce cravings, and help the body adjust to a drug-free state.

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Best Medications for Alcohol Withdrawal

There are three FDA-approved medications used in MAT for alcohol use disorder. These medications are not addictive and are used as part of a long-term treatment plan. They include:

Acamprosate

This medication reduces or prevents symptoms caused by alcohol withdrawal and the aftermath. It is for people who are not currently drinking and want to avoid drinking. It does not prevent withdrawal symptoms. Most people begin using this drug approximately five days after their last drink. It comes in tablet form and is taken three times per day. Side effects include:

  • Dizziness
  • Diarrhea
  • Upset stomach
  • Appetite loss
  • Difficulty sleeping
  • Anxiety

Disulfiram

This medication causes unpleasant symptoms when someone drinks alcohol. It’s most effective for people who have completed detox and are in the early days of abstinence. It’s available in tablet form. People who have been drinking or who have had a drink within the last 12 hours should not take it. When mixed with alcohol, a variety of negative symptoms occur within 10 minutes and last up to an hour or more, including:

  • Chest pains
  • Nausea
  • Headaches
  • Difficulty breathing
  • Vomiting

Naltrexone

This medication stops cravings for alcohol by blocking certain receptors in the brain that produce feelings of euphoria and intoxication. It helps people with AUD reduce their use of alcohol and stay motivated to remain in treatment, use their medication, and avoid relapse.

In addition to the medications listed above, other medications are also used to ease withdrawal, avoid central nervous system problems, prevent seizures, and reduce the risk of DTs. Sedative medications used in alcohol withdrawal include:

  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Chlordiazepoxide (Librium)
  • Oxazepam
  • Baclofen: Skeletal muscle relaxant
  • Carbamazepine: Anticonvulsant
  • Gabapentin: Anticonvulsant

The above-listed benzodiazepines and other medications are used to treat many conditions, including helping someone through alcohol withdrawal. They can be used alone or in combination with other drugs, including those listed above and clonidine and haloperidol. Pharmacotherapy should occur in combination with psychiatry and mental health support.

Benefits of MAT for Alcohol Withdrawal Syndrome

MAT is a clinically effective treatment used for recovery. It is a comprehensive approach that improves the effectiveness of behavioral therapy.  MAT staves off cravings and helps recovering addicts remain abstinent. MAT requires specific FDA-required medications.

The ultimate goal of MAT is complete recovery. Benefits of MAT include:

  • Increases patient survival rates
  • Eases the effects of or prevents acute alcohol withdrawal syndrome
  • Improves patient’s ability to recover and lead a fulfilling life as a fully participating member of society
  • Increases retention in treatment and recovery programs
  • Decreases criminal activity associated with alcohol and drug use
  • Improve birth outcomes among mothers with a substance use disorder
  • Decreases risk of contracting HIV, hepatitis, and other diseases associated with alcohol and drug use

Where to Undergo MAT

Several reputable establishments offer MAT and management of alcohol withdrawal syndrome. Medications used in recovery are highly regulated and can only be used in medically supervised environments.

If you are interested in finding treatment centers that provide MAT, speak with an addiction specialist today.

Resources

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“Can You Die from Alcohol Withdrawal? Here’s What to Know.” Healthline, 16 Aug. 2019, www.healthline.com/health/alcoholism/can-you-die-from-alcohol-withdrawal#prevention

 “Medication-Assisted Treatment (MAT) | SAMHSA - Substance Abuse and Mental Health Services Administration.” Samhsa.gov, 21 July 2015, www.samhsa.gov/medication-assisted-treatment.

“MAT Medications, Counseling, and Related Conditions.” Samhsa.gov, www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions#medications-used-in-mat.

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