Your doctor may also perform a toxicology screen , which tests how much alcohol is in your body. Healthcare professionals may use this test to diagnose AWS. It can also be used to determine the severity of your symptoms. The scale measures the following 10 symptoms:. According to a study , the use of the Objective Alcohol Withdrawal Scale OAWS was more useful for treatment because it can be used as a framework and tailored to individual cases.
Treatment for AWS depends on how severe your symptoms are. Some people can be treated at home, but others may need supervised care in a hospital setting to avoid potentially dangerous complications such as seizures.
The first goal of treatment is to keep you comfortable by managing your symptoms. Alcohol counseling is another important treatment goal. Mild symptoms of AWS can often be treated at home. A relative or friend must stay with you to monitor your condition. Their job is to make sure that if you develop any worsening of symptoms, they get you to a hospital or call immediately. They should also make sure you attend your counseling appointments and visit the doctor regularly for any routine blood tests that may be ordered.
You may also need tests for alcohol-related medical problems. If your home environment is not supportive for staying sober, talk with your doctor. Your doctor may be able to connect you with shelter programs for people recovering from alcohol addiction.
If your symptoms are more severe, you may need to stay in the hospital. This is so your doctor can monitor your condition and manage any complications. You may need to get fluids intravenously , or through your veins, to prevent dehydration and medications to help ease your symptoms. Symptoms of AWS are often treated with sedatives called benzodiazepines.
The most prescribed benzodiazepine is chlordiazepoxide, which is only available as a generic in the United States. Many agents other than benzodiazepines have been used for managing AW.
In fact, a few studies have demonstrated that long-acting barbiturates can ease withdrawal symptoms. Furthermore, barbiturates have a narrow therapeutic index—that is, the difference between the minimum dose required for a therapeutic effect and the dose at which the agents become toxic is small. Alcohol itself also would be expected to improve withdrawal symptoms, and alcoholic patients know that alcohol consumption can relieve their symptoms.
Alcohol should not be used, however, to treat withdrawal for several reasons. First, using alcohol as a treatment would promote its acceptability to the alcoholic.
Second, alcohol has known toxic effects e. Third, in one clinical study, alcohol was inferior to the benzodiazepine chlordiazepoxide. Clonidine—an antihypertensive medication—also may have a role in the management of withdrawal symptoms, although it has not been shown to affect the occurrence of withdrawal-specific complications. Another agent that has shown promise for managing AW is the anticonvulsant carbamazepine.
Animal studies have demonstrated that the medication may prevent seizures. Moreover, it does not interfere with mental processes, such as learning, whereas other agents e. Carbamazepine also does not potentiate alcohol-induced depression of the CNS, nor does it affect respiratory function. In addition, unlike the benzodiazepines, carbamazepine does not have the potential for abuse. Finally, carbamazepine may prevent kindling.
This agent has not been shown, however, to prevent withdrawal-specific complications, and it can cause substantial side effects, including nausea and dizziness.
For more information on other medications used in the treatment of withdrawal symptoms, see the article by Myrick and Anton, pp. Other medications can serve as effective adjuncts to care. For example, beta-blockers e. Consequently, these agents should be used only in combination with benzodiazepines.
In general, the use of beta-blockers for treating withdrawal should be considered primarily for patients with coexisting coronary artery disease. Antipsychotic medications such as haloperidol can treat hallucinations and agitation that are unresponsive to adequate doses of benzodiazepines. Because antipsychotic medications can increase the risk of seizures, however, these agents should be used only in combination with benzodiazepines.
AW seizures generally can be prevented by medications that are cross-tolerant with alcohol. For example, benzodiazepines have been shown to prevent both initial and recurrent seizures. Similarly, carbamazepine and the barbiturate phenobarbital probably can prevent AW seizures, although insufficient data exist in humans to confirm this hypothesis. In contrast, phenyotin, an anticonvulsant medication used for treating seizures caused by epilepsy and other disorders, is ineffective for treating AW seizures.
Because a diagnosis of AW-related seizures may require further evaluation, however, the agent is sometimes administered until other causes of seizures have been ruled out. Nonetheless, diazepam can improve outcome by rapidly inducing a calm, awake state, thereby avoiding the traumatic complications associated with severe agitation Thompson et al.
Constant monitoring is essential for patients experiencing this serious complication. Traditionally, patients undergoing AW have been treated in hospitals and inpatient alcohol and other drug AOD abuse treatment programs. For patients without severe withdrawal or complicating illnesses, inpatient or outpatient AOD treatment settings are appropriate.
Withdrawal in settings that offer less intensive monitoring, however, should be considered with caution. For example, as noted previously, the risk factors for more severe withdrawal still need to be better defined.
Furthermore, although numerous studies of diverse treatment settings have reported favorable outcomes, many of these studies have included patient groups that were referred specifically to the particular setting being studied.
Other studies have included only patients specifically selected for being at low risk for severe withdrawal. Thus, these studies may have been biased toward finding successful outcomes.
In the only randomized trial, patients with mild to moderate withdrawal received pharmacological treatment as either inpatients or outpatients Hayashida et al. Although outcomes at 6 months did not differ between inpatients and outpatients, fewer outpatients than inpatients completed the treatment and achieved abstinence 1 month later. For more information on inpatient versus outpatient detoxification, see the article by Hayashida, pp.
AW is often treated, discussed and studied as an entity distinct from alcoholism treatment. One should remember, however, that withdrawal and its treatment represent a brief period of time i. Researchers do not yet know whether the choice of detoxification method has an impact on long-term patient outcomes.
For example, one may speculate that early treatment may prevent more serious symptoms during subsequent withdrawal episodes. Furthermore, treatments both pharmacological and nonpharmacological that make patients more comfortable may encourage patients to engage in further treatment for their underlying alcohol use disorder and help prevent relapse. Alcoholic patients are at risk for relapse for numerous reasons, including inadequate treatment of their withdrawal symptoms, continued expectations of the rewarding effects of alcohol, and feelings of distress in the absence of alcohol.
Effective treatment of withdrawal only addresses the first of these reasons Dupont and Gold Nevertheless, for patients who seek assistance with detoxification, treatment of their withdrawal symptoms may present a window of opportunity for initiating alcoholism treatment as well as for attending to other coexisting medical and psychiatric disorders Samet et al.
Accordingly, appropriate recognition and treatment of AW can represent an important, albeit small, first step toward recovery. Many unanswered questions remain regarding AW and its management.
For example, researchers still must clarify the exact molecular and genetic mechanisms responsible for the varied manifestations of withdrawal. Other studies should address the clinical significance of kindling and the risk factors for more severe withdrawal Fiellin et al. Additional research also is needed to determine the most appropriate treatment settings as well as methods of engaging patients in ongoing relapse prevention efforts. Finally, research should investigate techniques to translate knowledge into clinical practice e.
Improved insight into these issues will enable clinicians to improve the efficiency and quality of care for patients who are experiencing or are at risk for withdrawal. People with moderate-to-severe symptoms of alcohol withdrawal may need inpatient treatment at a hospital or other facility that treats alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens.
If you have mild-to-moderate alcohol withdrawal symptoms, you can often be treated in an outpatient setting. During this process, you will need someone who can stay with and keep an eye on you. You will likely need to make daily visits to your provider until you are stable. It is important to go to a living situation that helps support you in staying sober.
Some areas have housing options that provide a supportive environment for those trying to stay sober. Permanent and life-long abstinence from alcohol is the best treatment for those who have gone through alcohol withdrawal. How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.
Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver, heart, and nervous system disease. Most people who go through alcohol withdrawal make a full recovery. This is when you may experience the most uncomfortable of withdrawal symptoms, such as insomnia, rapid heartbeat, changes in blood pressure, sweating, tremors, and fever.
While some people experience very few withdrawal symptoms, others may suffer from more serious side effects. For example, delirium tremens is one of the most severe of alcohol withdrawal symptoms. It can surface within the first 48 hours after your last drink and involves confusion, severe shaking, hallucinations, and high blood pressure. Although delirium tremens is uncommon, it can be life-threatening.
Symptoms of alcohol withdrawal typically improve within five days, though a small number of people may have prolonged symptoms. The severity and duration of alcohol withdrawal symptoms are impacted by several factors, including frequency of drinking, amount consumed during drinking, length of time drinking, medical history, and co-occurring health conditions.
Take your life back by getting started in a treatment program today. Over the course of the first few days and weeks after someone stops drinking alcohol, he or she may experience acute alcohol withdrawal symptoms. Acute alcohol withdrawal syndrome refers to the common withdrawal symptoms a heavy drinker experiences when they suddenly reduce the amount of alcohol they drink after prolonged periods of heavy use. Because of the life-threatening health complications that can arise during acute alcohol withdrawal, it is recommended that you never attempt to quit on your own and that you instead stay at a hospital or a specialized rehab facility for treatment.
Medical professional can assess your mental and physical health frequently throughout the day to make sure symptoms do not escalate. After the initial alcohol withdrawal symptoms have subsided, some people may experience prolonged side effects. This phase is less common and is known as post-acute withdrawal syndrome PAWS. PAWS involves withdrawal symptoms that occur after acute withdrawal and can make post-rehab life challenging for some individuals.
Depending on the severity of your alcohol abuse , PAWS can last anywhere from a few weeks to a year. In general, PAWS symptoms peak around four to eight weeks after quitting. PAWS is one of the leading causes of relapse for individuals that have completed alcohol addiction treatment. The spontaneity of this withdrawal phase can make resisting temptation hard.
If an individual can hang on during that time frame, the symptoms will resolve just as quickly as they appeared. Alcohol withdrawal symptoms can shift quickly and violently — you can experience minor symptoms to extremely severe side effects in a matter of hours.
There are many alcohol treatment programs that focus on helping individuals overcome drinking problems, no matter how minor or how serious.
Specialized rehab facilities offer many benefits to those struggling with alcohol addiction. Inpatient rehab facilities offer a safe, supervised environment for patients struggling with alcohol addiction.
With hour care, this is the most intensive form of treatment and typically entails 30, 60 or day programs. Outpatient rehab allows patients to attend to their daily responsibilities while in recovery.
This option is best suited for those with less severe forms of alcohol abuse since individuals will be around drinking triggers and other influences. To help relieve uncomfortable withdrawal symptoms, many treatment programs offer medication-assisted therapy.
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