Alcohol Withdrawal Medications: What Helps With Alcohol Withdrawal?
Detoxing from alcohol is a stressful and oftentimes painful process. It is one of the most challenging parts of overcoming alcoholism, and unfortunately, it is one of the first steps that anyone struggling with alcohol dependency must take. Alcohol use disorders (AUDs) include many different variations of alcoholism. It is not unfair to say that alcoholism can manifest itself differently in almost everyone who experiences it.
There are many “functioning alcoholics” who are able to hide their substance abuse and dependence from friends and family. There are also those who become more chronic drinkers, drinking to the point of drunkenness and obviousness routinely. Regardless of how well they may have hidden their dependency from loved ones, it is unlikely to be as simple to hide the withdrawal symptoms.
The chronic or excessive use of alcohol can lead to significant physical dependence, and this can lead to painful withdrawal symptoms when that individual makes the choice to stop drinking.
Withdrawal occurs due to the adaptive changes that the body undergoes after drinking alcohol too often and too heavily. The reason that alcohol is addictive is because it is a central nervous system depressant.
When people drink heavily over an extended period of time, their body begins to adjust to the presence of alcohol in the system. The body even starts to build a tolerance to alcohol so that it can maintain equilibrium easier with the constant influx of the substance.
To create a tolerance for higher levels of alcohol in the system, the body specifically adjusts neurotransmitter levels, which impacts the nervous system and sensory awareness.
Quitting drinking causes the body to readjust to the absence of these neurotransmitters, and that sudden change disrupts a series of physiological processes, leading to what is essentially overexcitement of the nervous system.
This is what causes the symptoms that we associate with a withdrawal, which at the most severe level can even include seizures. It will almost always include anxiety, irritability, and nausea, however.
Here is a quick breakdown of the different symptoms of alcohol withdrawal:
- Clammy skin
- Tremors, especially in the hands
- Increased anxiety and nervousness
- Increased blood pressure
- Sudden mood swings
These symptoms are uncomfortable. They can impact your quality of life, affect your ability to focus at work, and even cause damage to relationships, thanks to your irritability and mood swings.
However, none of these symptoms are as terrifying as the experience of isolated seizures, as well as the development of what is referred to as DTs, or Delirium Tremens. These are severe and potentially life-threatening. DTs cause bouts of severe confusion, hallucinations, fever, rapid heartbeat, and seizures, and they frequently require hospitalization.
Why Medical Support Is a Good Idea for Quitting Alcohol
Alcohol withdrawal can be dangerous. The more dependent an individual is on the substance, the more likely there will be a severe withdrawal from that substance. Medical supervision is heavily encouraged for anyone who is planning to quit drinking.
The choice to quit drinking is life-changing. This is a decision to take ownership of your life back from a substance that is forcing you to make choices that are damaging to your physical, mental, social, and even financial well-being.
There are a series of medically supervised detoxification programs and treatments available to help manage symptoms and prevent complications that can develop during the withdrawal process.
Types of Medications That Support Alcohol Dependency Recovery
Physicians have developed a series of medications that can help reduce the experience of withdrawal symptoms. This is a huge breakthrough in alcohol recovery because it helps people get over the biggest barrier that separates far too many from living free from substance dependency.
Utilizing the medications to manage the symptoms of withdrawal are actually shown to reduce the risk of more severe withdrawal episodes, including the risk of seizures and DTs. This means that working with a physician to manage the discomfort of the withdrawal process can be life-changing.
The primary types of medications prescribed for overcoming alcohol dependency and the treatment of alcohol withdrawal are:
- Disulfiram (Antabuse)
- Naltrexone (Vivitrol, Revia)
- Acamprosate (Camprall)
Understanding the Differences of Alcohol Withdrawal Medications
Many of the leading medications frequently prescribed for recovery from alcohol abuse are drugs that are scheduled for the treatment of other medical concerns, ranging from seizure prevention to management of anxiety and depression.
Benzodiazepines, commonly called “benzos,” are a class of sedatives that are frequently prescribed for bouts of panic, anxiety, and can even be used to manage certain types of seizure disorders. These are the most common types of medication used to treat the discomfort of alcohol withdrawal thanks to their availability and effectiveness.
The most commonly prescribed benzos for alcohol withdrawal are Librium (generically sold as chlordiazepoxide) and Valium (generically sold as diazepam).
Those who have chronic liver issues or who are over the age of 65 may require a more short-acting medication rather than the more regularly prescribed benzos.
There are four benzodiazepines that are approved by the FDA to treat acute alcohol withdrawal symptoms. These include:
The biggest drawback to benzodiazepines is that they are habit-forming, which could replace one dependency with another. The use of these medications needs to be managed closely by a physician.
One of the most dangerous and life-threatening symptoms of alcohol withdrawal is seizure. Anticonvulsants are frequently used to prevent seizure and are sometimes prescribed to support the withdrawal process. Depending on individual needs, the anticonvulsant may be prescribed in addition to another withdrawal medication, like benzo, or on its own.
These medications include:
- Valproic Acid
While the use of anticonvulsants can be incredibly helpful, they may not be enough on their own to outright stop the development of a grand-mal seizure, nor will they prevent the experience of DTs.
In cases where benzos prove to not be sufficient, barbiturates may be introduced as a follow-up. Barbiturates are more commonly introduced in the emergency room, where there is a severe need for medical intervention after alcohol withdrawal symptoms have become too severe for clients to manage on their own.
Medical Support to Quit Drinking Outside of Withdrawal Management
Sometimes, supporting the symptoms of withdrawal isn’t enough to encourage individuals to quit drinking. This is the case when people are having trouble giving up drinking. Treating withdrawal isn’t relevant yet because they are still consuming alcohol and therefore still feeling the effects of alcohol.
There is an additional group of medications that are designed for this scenario.
For some who struggle with alcohol dependency, the need to stop drinking is a challenge. Disulfiram inhibits the metabolization of alcohol in the body. When taking this medication, even a small amount of alcohol will lead to a variety of unpleasant side effects, such as anxiety, blurred vision, nausea, vomiting, and more.
The idea behind disulfiram is to create a negative association with alcohol consumption, thereby discouraging the individual from drinking. This medication doesn’t actually stop the symptoms of withdrawal but instead helps to act as a backstop for those who are likely to try drinking again.
Naltrexone is one of the oldest FDA medication types for the treatment of alcohol dependency and withdrawal. It is also recognized as helpful in treating those who abuse opioids.
Similar to disulfiram, naltrexone does not manage the symptoms of withdrawal. Instead, this medication reduces the urge and desire to drink, supporting an individual’s desire to stay abstinent and reducing the feelings of enjoyment that come from drinking alcohol.
Taken over a long period of time, naltrexone can lead to liver damage. This is why it is recommended that users take it while trying to quit drinking. Once initial abstinence is gained, the continued use of naltrexone is not recommended.
Acamprosate fits into the same camp of medications such as naltrexone and disulfiram to the extent that it is prescribed to help an individual during the process of quitting drinking. This medication is recommended as part of a counseling program, providing a balancing effect within the central nervous system that helps the body adjust back to “normal” without the symptoms of withdrawal.
Specifically, acamprosate works to re-create balance between the glutamate and gamma-aminobutyric acid (GABA), thereby reducing the extreme sensory experiences and discomfort that come from quitting alcohol.
A big advantage of acamprosate is that it does not impact the liver, and it also does not create an adverse reaction when alcohol is consumed. Therefore, this medication is ideal for those who are trying a slower approach to quitting, as well as for those who have liver disease or hepatitis.
The Takeaway: Contact your Doctor for Support
Quitting drinking is an honorable decision that is going to be challenging but worth it in the long run. For those who have an alcohol dependency, quitting drinking will likely take more than a resolute attitude. Reaching out for medical support is not a sign of weakness–it is a sign of strength. It is a recognition that you are in need of support and that you are willing to use whatever resources are available to you to improve your health and lifestyle.
At Alcohol Awareness, we have specialists who are trained to support people from all walks of life with the withdrawal process, helping to make the journey away from alcohol as painless and productive as possible. For more information about medical support for overcoming alcoholism or for support with taking the first steps to quit drinking, contact us.