What Is Alcohol Use Disorder?
Alcohol addiction, alcoholism, and alcohol use disorder (AUD) are all terms for the disorder characterized by drinking excessive alcohol and having no control over how much you drink. AUD falls under substance use disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Anyone can suffer from an alcohol use disorder. The disease affects men, women, and teens of all ages. Some ethnic groups have higher rates of alcoholism than others.
Key characteristics that define AUD include:
- Loss of control: Those with AUD have no control over their drinking. They are unable to stop when they want to, and once they start drinking, they have trouble stopping.
- Increased tolerance: As the body becomes accustomed to alcohol in the system, people with alcohol use disorder need more alcohol to feel the same effects. As a result, they consume larger and larger amounts.
- Withdrawal symptoms: Alcoholics typically go through withdrawal symptoms when they suddenly stop drinking alcohol.
- Drinking despite negative consequences: When people continue to drink despite negative consequences, such as a job loss, loss of a relationship, or legal issues like an arrest for drunk driving, it’s usually a sign they have an alcohol addiction.
- Hiding alcohol use: When individuals have an alcohol addiction, they may try to hide how much they are drinking from friends and family for fear of judgment.
- Frequent blackouts: Those with an alcohol use disorder may experience frequent blackouts after drinking to excess.
What Happens When You Withdraw From Alcohol?
If you recognize that you have an alcohol problem and would like to stop drinking, be aware that you may experience withdrawal symptoms. The severity of your symptoms will depend upon various factors, such as the length of time you have been drinking heavily, the severity of your addiction, and whether you have co-occurring disorders, such as depression or anxiety.
Symptoms you may experience once you stop consuming alcohol include:
- Tremors: Your hands may visibly shake if you haven’t had a drink in a few hours. This is especially noticeable in the morning.
- Sweating: As the body attempts to eliminate all the toxins in alcohol, you will sweat profusely.
- Insomnia: When going through withdrawal, you may have trouble going to sleep or staying asleep.
- Anxiety: You may feel anxious and irritable.
- Nausea and Vomiting: These symptoms can last for hours or even days.
- Delirium tremens (DTs): In severe cases of alcohol withdrawal, individuals experience visual or auditory hallucinations, intense tremors, and feelings of confusion. DTs can be life-threatening.
- Seizures: In rare cases, there may even be alcohol withdrawal seizures.
What Is Antabuse?
Antabuse, whose generic name is disulfiram, is a medication used to help those who have an alcohol use disorder. The FDA approved it over 70 years ago to treat alcohol use disorder.
Disulfiram prevents the enzyme aldehyde dehydrogenase from metabolizing ethanol, the key ingredient in alcohol. As a result, when users drink alcohol while on Antabuse, they suffer extreme negative reactions. Because of these negative reactions, Antabuse is used to help people stop drinking.
Some of the symptoms that people experience when they combine alcohol and Antabuse include:
- Red, flushed appearance
- Heart palpitations
- Nausea and vomiting
- Dizziness
- Difficulty breathing
How Antabuse Should Be Used
Antabuse is prescribed by doctors and should be taken once daily, preferably in the morning. This medication should be taken at the same time every day to get the most benefit.
If you stop taking Antabuse, the medication can remain in your system for up to two weeks and will react with any alcohol you consume. People with cardiac disease and heart problems should not take Antabuse.
Can Antabuse Help When You’re Withdrawing From Alcohol?
Antabuse does not reduce alcohol cravings or help with withdrawal. It is typically prescribed after individuals go through detox.
During detox or the withdrawal process, healthcare professionals focus on medications or treatments that can alleviate withdrawal symptoms rather than complicate them. As a result, they may prescribe medications to help with a person’s anxiety, depression, or insomnia. In addition, some people may require medication for seizures or delirium tremens.
Once an individual has completed detox and is no longer experiencing severe withdrawal symptoms, doctors can introduce Antabuse. Antabuse can then be combined with additional treatment plans, such as behavioral therapy.
Some people may choose to stop drinking at home and may ask their doctor to prescribe them Antabuse. If so, it’s important not to take Antabuse until the withdrawal symptoms have subsided. Starting Antabuse too soon — especially if you have a severe alcohol addiction — can be harmful. In fact, doctors emphasize that Antabuse should not be taken if you have consumed alcohol within the last 12 hours. In addition, when taking Antabuse, stay away from anything that contains alcohol, such as mouthwash, cough medicine, cooking wine, or vinegar.
What Medications Can Help With Alcohol Withdrawl?
Although Antabuse does not help when you’re withdrawing from alcohol, there are other medications that can help ease the withdrawal symptoms caused by alcohol or help reduce cravings. These include:
Acamprosate (Campral)
Those with severe alcohol use disorder tend to have an imbalance of the neurotransmitters. The medication acamprosate can help restore the balance of both the glutamate and GABA neurotransmitters. When the balance is restored, individuals experience fewer alcohol cravings.
Acamprosate can also help alleviate some of the withdrawal symptoms, such as insomnia and anxiety. Besides helping with the initial withdrawal symptoms, people with AUD can continue to take acamprosate as part of their treatment plan.
Naltrexone
Naltrexone blocks the effects of opioids and alcohol. By so doing, the medication reduces the pleasurable effects that alcohol offers. It also reduces cravings for alcohol, helping people maintain sobriety.
Like with other medications that help people with AUD, naltrexone is typically used in combination with an effective treatment plan. Besides oral doses, Naltrexone is available in an extended-release injectable form that is given monthly.
Like Antabuse, Naltrexone should be used after detoxing. If you have just completed a detox program, wait seven days before starting Naltrexone.
Topiramate
Like acamprosate, topiramate helps balance the two neurotransmitters glutamate and GABA. Chronic alcohol abuse can cause your glutamate levels to rise. Topiramate has inhibitory effects on glutamate, which can lower the levels in your body. In turn, this can reduce your cravings for alcohol. Topiramate also helps alleviate anxiety in those withdrawing from alcohol.
Benzodiazepines
Benzodiazepines are especially effective with those suffering severe withdrawal symptoms, such as seizures. Benzodiazepines help suppress the overactive GABA neurotransmitters during the alcohol withdrawal stage. These medications also have sedative effects, so they can help with anxiety and insomnia as well.
For those suffering from delirium tremens, Benzodiazepines can be lifesaving. Their sedative effect can not only manage delirium tremens but also help prevent it.
Why Medical Supervision Is Critical When Withdrawing From Alcohol
For those suffering from severe AUD, medical supervision is important while withdrawing. Withdrawing from alcohol can result in either mild and manageable symptoms or more severe ones that can be life-threatening. Here are some reasons why it’s important to have 24/7 supervision when you are experiencing withdrawal symptoms.
Risk of Severe Symptoms
Some people suffering from intense withdrawal symptoms may experience delirium tremens. Symptoms of DTs may include an elevated heart rate, hallucinations, and confusion. Healthcare professionals can prescribe Benzodiazepines to help manage them.
Possible Medical Complications
Chronic alcohol abuse can lead to an imbalance of neurotransmitters, dehydration, and an electrolyte imbalance. Healthcare providers must ensure that you get enough fluids and electrolytes in your system as you are withdrawing. If not, there may be complications.
Anxiety and Irritability
Many people who are withdrawing from alcohol will experience insomnia, anxiety, and irritability. These can range from mild to intense. To help make these symptoms manageable, healthcare professionals can offer clients medication, such as benzodiazepines. Ignoring these symptoms may cause clients to harm themselves or others.
Possible Co-Occurring Disorders
According to the 2021 National Survey on Drug Use and Health, approximately 9.2 million U.S. adults have a co-occurring disorder. Healthcare professionals who are standing by can be alerted to a co-occurring disorder while a client is detoxing. If a person withdraws without supervision, the combination of having AUD and a mental health disorder can be life-threatening. However, when medical team members are present 24/7, they can be alerted to any co-occurring disorder and provide the appropriate treatment.
Prevention of Seizures
In extreme cases, those withdrawing from alcohol may suffer seizures. With 24/7 supervision, medical staff can save a person’s life if a seizure happens under their watch.
What Treatment Is Available for Alcohol Use Disorder?
Having an alcohol use disorder can be rather complex as there may be various factors that cause chronic abuse. In addition, clients may come in with co-occurring disorders, which means healthcare professionals must customize a treatment plan to address both the mental health disorder and the alcohol use disorder.
Here are some standard treatment plans that have proven to be effective.
Behavioral Therapies
Behavioral therapies, or talk therapies, focus on encouraging clients to talk about their alcohol abuse: what caused it and what the triggers are. Cognitive Behavioral Therapy (CBT): CBT helps clients to change unhelpful ways of thinking into more positive ones. They learn coping mechanisms and problem-solving skills to support their sobriety. Dialectal Behavioral Therapy (DBT) is also useful when treating people with AUD. Like CBT, this type of therapy helps clients manage thoughts and behaviors. However, the emphasis is more on controlling emotions that may trigger a relapse.
Medical Detox
As mentioned above, withdrawing from alcohol can lead to severe symptoms. Individuals with AUD are sometimes prescribed medication that can help smooth out the rough edges that come with intense withdrawal symptoms.
12-Step Programs
Some 12-step programs, such as Alcoholics Anonymous (AA), provide community support to those suffering from AUD. Although it is not group therapy, it helps people know they are not suffering alone. There are also sponsors within the group who can help new members maintain their sobriety through guidance and one-on-one meetings.
Rehab Programs
For those who have been abusing alcohol for years or have tried to quit drinking and failed, entering a program at a treatment center may be the best option. Here are some choices.
- Inpatient Rehab: Inpatient rehab programs require you to stay at the rehab facility for a specific time. This can be anywhere from two weeks to six months. Inpatient rehab programs offer detox as well as customized treatment plans that include behavioral therapy, group therapy, and more.
- Outpatient Rehab: Outpatient rehab programs are similar in structure to inpatient rehab programs and start with detox. The only difference is you stay at home and can go to work or school while attending the program.
The Alcohol Awareness Hotline
At Alcohol Awareness, we know how hard it is to achieve a sober lifestyle because we are recovering alcoholics ourselves. If you or someone you care about has developed a problem with alcohol, call our free 24/7 hotline. First and foremost, we can listen when you need to talk. We can also direct you to alcohol use disorder resources, including rehab programs and AA groups near you.