This article has been medically reviewed by Dr Robert Lefever, a world-leading addictions specialist.
When constant or extreme alcohol has been in use, you might encounter withdrawal symptoms after you have made up your mind to stop alcohol intake. For those in danger of severe alcohol withdrawal, doctors might recommend certain medications to prevent the deterioration of the symptoms and limit the chances of additional withdrawal complications.
What are the alcohol withdrawal symptoms that medications can help control?
Detox medications are not used to cure alcohol dependence. However, some of the symptoms that detox medication can help to minimise are:
- Alcoholic Seizures
- Excessive sweating
- Dashing pulse – tachycardia
- Loose bowels
- A sleeping disorder
- Alcohol cravings
Detox medications work perfectly to reduce the severity of these symptoms.
Importance of alcohol detox
Alcohol detox is the first step of treating alcoholism. Alcohol detox is a carefully supervised approach administered by a specialist, during which they focus on eliminating alcohol from your body. Withdrawal symptoms will start to show up after a few days or weeks, depending on the severity of alcohol dependency. After that, you will be able to continue with other recovery measures such as therapies, support groups, and counselling sessions.
Alcohol is a depressant that your body starts to depend on after months or years of drinking. In the long run, your brain quits creating certain chemicals that it derives from alcohol, hence becoming dependant on alcohol. This is why when you stop alcohol consumption, your body will take some time to adjust. Quitting alcohol can lead to headaches, fever, hallucination, tremors and various other complications.
Withdrawal side effects can change rapidly and forcefully, which is why detox should be done under the supervision of clinical experts. Treatment experts at rehabilitation centres will give you certain medications which will help reduce withdrawal symptoms.
Supervised medical detox
Withdrawal from long term alcohol use is much safer under the supervision of a doctor. Therefore, doctors usually prescribe medication to alcohol addicts to gradually reduce alcohol consumption and manage alcohol withdrawal symptoms.
Before participating in detox, you will be required to provide a medical report and an honest account of how long you have been involved in alcohol intake. For this reason, it is advisable to seek professional medical help on which medications to use since some medicines are not appropriate for particular people.
Additionally, it is not good to self-medicate if you want to achieve withdrawal from alcohol dependence. There is no medication to cure alcoholism. Nonetheless, medication can help in alcohol addiction treatment when used with other approaches such as therapies.
What are the medications used during alcohol detox?
When alcohol detox is treated in an inpatient rehab setup, various drugs might be utilised to lessen stubborn withdrawal side effects. Medications can likewise help keep an individual’s body’s chemicals in balance, bringing down the danger of genuine complications. In recovery, a clinical expert will control the medicine and screen its effects.
Different medicine options can be used if certain medications result in undesirable incidental effects or meddle with the detox process. Some of the medicines that are generally used during the detox stage are:
Benzodiazepines are a class of medications usually used to treat pressure, yet they can still treat alcohol withdrawal symptoms during alcohol detox.
Benzodiazepines help to calm the central nervous system and can be used to treat insomnia and anxiety.
The most commonly used benzodiazepines are: Chlordiazepoxide (Librium), Diazepam (Valium), Clonazepam, and Lorazepam.
Librium and diazepam are primarily used in rehabs for alcohol detoxification unless there is a contrary medical reason.
Valium and chlordiazepoxide are licensed to treat alcohol dependence. Medically, these drugs are authorised and approved by NICE for liquor withdrawal and detoxification.
Benzodiazepines are likewise regularly used and abused casually due to the lovely euphoric and narcotic-high effect. They are among the most commonly used physician endorsed drugs in the UK and throughout the world.
Benzodiazepines generally come in tablet form but can also be administered directly to your vein using a needle or directly to your muscles by an injection. A few specific benzodiazepines can also be used during intranasal (through the nose), rectal and vaginal administration.
Benzodiazepines are associated with the following side effects:
- Transient tiredness is usually experienced during the initial periods of treatment.
- Loss of direction
- Memory loss
Benzodiazepines can cause absolute dependence. When you stop treatment unexpectedly, you might get withdrawal symptoms that combine a loss of confidence, disruption and a resting problem.
If benzodiazepines are taken consistently for more than a couple of months, stopping treatment immediately may lead to seizures, quakes, muscle squeezing, heaving, and sweating. To stay away from withdrawal side effects, benzodiazepines dosages ought to be reduced gradually.
What are the alternatives medications to treat alcohol dependence?
Besides benzodiazepines, doctors may prescribe other medications to help in alcohol withdrawal, such as:
Clomethiazole is prescribed in an inpatient setting to treat alcohol withdrawal. Clomethiazole is not prescribed to patients with liver cirrhosis and can be fatal if mixed with alcohol.
Carbamazepine is used to treat epilepsy but can also be used for alcohol detoxification. However, close monitoring will be needed as carbamazepine can cause self-destructive thoughts and practices.
The significant advantage of the above alternatives is that they have less abuse potential than benzodiazepines.
What are the FDA-approved medications for alcohol addiction and dependence?
These medications come in tablet form and can help reduce alcohol desire, block alcohol effects and cause a reduced interaction with alcohol.
Apart from medications that are used to treat alcohol withdrawal syndrome, the following drugs can be used by alcoholics within the recovery program to treat alcoholism:
1. Disulfiram (Antabuse)
Antabuse was the primary medication supported by Food and Drug Administration to treat both alcohol use and dependence.
When you take alcohol, your body utilises and makes acetaldehyde, a toxic substance that causes migraines after significant drinking. Consistently, acidic acid, which causes no harm, will be produced by your body due to the oxidisation of acetaldehyde.
Antabuse hinders the oxidation of acetaldehyde into acidic acid, causing much acetaldehyde after drinking alcohol.
Blending alcohol with Antabuse is related to specific symptoms. The seriousness of these symptoms, which goes from gentle to extreme, is subject to the measure of Antabuse and alcohol were taken. Side effects endure as long as the alcohol is present in your body. Some of these symptoms include:
- Copious vomiting
- Chest pains
- Blurred vision
- Low blood pressure
Extreme reactions may lead to heart attack, arrhythmia, cardiovascular collapse, intense congestive cardiovascular breakdown and death.
Antabuse ought to be given to anyone quitting alcohol drinking and clearly understands the outcome of blending alcohol with Antabuse. Of equivalent significance, Antabuse should not be given to anyone encountering coronary ailment and an allergy to Antabuse.
Antabuse is a pill that should be administered by a doctor to alcoholics daily. By stopping or skipping this drug intake, the addict can get back to alcohol hence reducing Antabuse effectiveness.
2. Acamprosate (Campral)
Acamprosate is used alongside counselling and social help to assist people who have quit drinking alcohol. Acamprosate is thought to re-establish a balance in the central nervous system between the glutamate and gamma-aminobutyric corrosive (GABA), excitatory and inhibitory synapses, respectively.
Drinking alcohol for quite a while changes how the brain works. Acamprosate works by aiding the brains of individuals who have consumed a lot of alcohol to work regularly once again. However, Acamprosate doesn’t stop the withdrawal indications that individuals might encounter when they quit drinking alcohol.
In addition, acamprosate has not been displayed to work in individuals who have not quit drinking alcohol or in individuals who drink a lot of alcohol and abuse or misuse different substances, for example, street drugs or doctor-prescribed drugs.
3. Naltrexone (Vivitrol)
Initially, naltrexone was used to treat opioid addiction. However, people in addiction recovery no longer experienced pleasure from opioid use, and therefore, they were motivated to stop drug abuse. With this in mind, scientists later discovered that naltrexone could have the same effects on alcoholics.
Naltrexone’s primary role is to lessen alcohol urges. It may be controlled very well during a managed detox measure or before treatment to reduce alcohol consumption. It might likewise be given as an enhancement to recovery to limit desires after an addiction treatment program.
Naltrexone has a long history of treating alcohol; however, it is not effective when used alone. To increase the effectiveness of naltrexone, it is essential to use it alongside other forms of treatment such as counselling and therapy. In addition, naltrexone has proven to be helpful in the treatment of alcoholics who have developed a relapse.
Alcoholics should take naltrexone under the supervision of a physician. Continuous use of naltrexone can lead to side effects like insomnia, dizziness, abdominal pains, headaches, anxiety and nervousness, nausea and vomiting, and tiredness.
Alcohol detox timeline
During the recovery phase following a medical evaluation, a patient will get a treatment plan and may require some prescription medications to limit the typical withdrawal conditions.
In addition, if your brain function has been altered after a long period of alcohol misuse, you might experience some symptoms. The severity of these symptoms varies from one person to the other. For this reason, you might require further hospital treatment.
According to Harvard Medical School, a rough timetable to alcohol withdrawal indications might look as follows:
- First 24 hours: You may start hallucinations which can last up to two days.
- 1 to 2 days: You may experience withdrawal-related seizures.
- 3 to 4 days: The significant side effect of alcohol is delirium tremens, which mostly requires treatment under the emergency unit. Delirium tremens can cause rapid heartbeats, dehydration and hypertension. Symptoms may include loss of consciousness, hallucinations, confusion, angry behaviour, and disturbed sleep.
- 5 to 7 days: Alcohol withdrawal symptoms start to improve, although few people may experience the symptoms for several weeks.
- Seven days and above: It’s good to abstain from alcohol after going through the alcohol withdrawal phase. For this purpose, you should take care of your mind and body. Inpatient or outpatient treatment programs can help you remain sober.
Prescriptions are not a solution for alcohol use problems
Withdrawal prescriptions are simply utilised as a guide for clinical detoxification or for helping you to keep up with restraint from alcohol. Therefore, the following should also be incorporated to help you overcome withdrawal symptoms and recover from alcoholism:
Alcoholics find self-help groups, such as Alcoholics Anonymous (AA), helpful since it is intended to help you overcome your addiction using a 12-step programme.
2. 12-step therapy
12-step therapy was introduced by Alcoholics Anonymous, where you work through the stages of alcohol withdrawal with one-on-one counselling rather than a group session.
3. Family therapy
Alcoholism does not only affect an individual, but it also affects family members at large. Because of this, family therapy will help family members to support an individual to stop alcohol abuse.
4. Cognitive behaviour therapy
Cognitive behaviour therapy helps by addressing your thinking and actions. The approach is aimed at helping alcoholics identify unrealistic thoughts and believes and base their behaviours on more realistic and helpful reviews.
5. Drinking diary
A drinking diary will help you moderate your drinking since it will give you a good idea of the triggers that lead you to drink, the amount of alcohol consumption, and how to cut down your alcohol intake.
What is the importance of alcohol detox?
Is it reasonable to self-detox?
What causes alcohol withdrawal syndrome?
Are alcohol detox medicines safe?
Are our alcohol detox medicines addictive?
- Medications Used to Treat Alcohol Withdrawal & Alcoholism
Detox medications are not used to cure alcohol dependence. In addition, withdrawal side effects can change rapidly and forcefully, which is why detox should be done under the guidance of clinical experts