Meds for Alcohol Withdrawal

Alcohol use disorder affects over 76 million people worldwide. Comprehensive treatments that include medication management can be a vital factor in helping people recover from alcoholism. During the initial detox process, many patients experience symptoms of alcohol withdrawal. A common method for targeting withdrawal symptoms includes medication-assistance treatment (MAT). The MAT method consists of prescribing various FDA-approved meds to alleviate uncomfortable symptoms of alcohol withdrawal. Benzodiazepines for alcohol withdrawal have been shown to be greatly effective for patient treatment.

What is Alcohol Withdrawal Syndrome?

Alcohol withdrawal syndrome (AWS) is defined as a cluster of symptoms that occur when a person drastically reduces the consumption of alcohol after heavy or prolonged use. AWS is a common side effect of people who suffer from alcohol addiction. Side effects of AWS can range from mild to severe, depending on how long a person has been drinking, how much a person drinks and how often a person drinks. For people who suffer from alcohol use disorders, daily consumption of alcohol results in physical and psychological dependence on the substance. The central nervous system in the brain is no longer able to function properly because it has become reliant on alcohol. As a result, the sudden imbalance in alcohol in the body can cause negative reactions.

In a dark room a person is holding a glass cup of alcohol while contemplating what meds for alcohol withdrawal will be safe.

Who is prone to Alcohol Withdrawal Symptoms?

Alcohol withdrawal syndrome is most commonly found in adults who are heavy drinkers. According to the CDC, a heavy drinker is a woman who drinks eight or more drinks per week, and a man who drinks 15 or more drinks per week. A heavy drinker who dramatically cuts down on drinking may experience withdrawal symptoms. A chronic drinker who decides to cut out drinking entirely and abruptly can also experience symptoms of alcohol withdrawal. 

When diagnosing AWS, physicians often look for physical signs that a person might be experiencing withdrawal symptoms. According to the Clinical Institute Withdrawal Assessment of Alcohol scale (CIWA-Ar), physicians explore a set of symptoms used to guide and measure AWS in a patient. This method is commonly used to diagnose AWS and can be used to determine the severity of symptoms. The scale measures 10 different symptoms that frequently occur in people who suffer from alcohol withdrawal.

  • Agitation
  • Anxiety
  • Auditory disturbances
  • Cloud of sensorium
  • Headache
  • Nausea and vomiting
  • Uncontrollable sweating
  • Tactile disturbances
  • Tremors and visual disturbances

What is the timeline for Alcohol Withdrawal Symptoms?

  • 6-12 hours – During this phase of alcohol withdrawal, minor symptoms begin to set in. These symptoms can include insomnia, anxiety, GI issues, headache and mild heart palpitations.
  • 12-24 hours – After a day of alcohol reduction, some people will experience alcoholic hallucinations such as visual, auditory or tactile hallucinations.
  • 24-48 hours – During this phase of AWS, symptoms become more intense and some people with severe addictions will experience withdrawal seizures.
  • 48-72 hours – During this phase of withdrawing from alcohol consumption, one of the most severe and deadly symptoms of alcohol withdrawal can occur: delirium tremens (DT). DT is an extreme medical condition in which a person can experience extreme confusion, intense hallucinations, fever and seizures.

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Why are benzodiazepines used for Alcohol Withdrawal?

Medication management programs such as MAT, are highly effective methods for treating patients with alcohol withdrawal symptoms. Patients are usually recommended this treatment during the initial detox phase of rehab. Under the care of medical professionals where medications can be administered safely and effectively, MAT can help alleviate the uncomfortable feelings that develop during withdrawal. Benzodiazepines (benzos) are a class of medications commonly used to treat AWS.

Due to its wide range of evidence-proven studies, benzos have become the gold standard for alcohol withdrawal treatment. Benzos are a class of controlled substances that fall under the sedative medications category. This medication is usually prescribed to treat mental health conditions such as anxiety, insomnia and seizures. While under the care and management of a physician, benzos are a safe and effective treatment path for AWS.

How do benzos and alcohol withdrawal coincide?

Benzos and alcohol create similar mirroring effects on the central nervous system in the brain. Benzos work by binding with the same chemical messengers in the brain that alcohol attaches to. These neurotransmitters are responsible for functions in the brain such as controlling a person’s anxiety levels. The benzos replace the effects of alcohol. It helps suppress the nervous system to provide a sense of calmness to reduce anxiety and prevent the development of other co-occurring mental health conditions.

The usage of benzos can result in a reduction of withdrawal severity, prevention of agitation and cravings, and can help prevent the onset of more severe symptoms. Like any other mind-altering substance, benzos can produce its own set of side effects including lethargy, dizziness, difficulty thinking and confusion.

What are the common types of benzodiazepines for Alcohol Withdrawal?

  • Chlordiazepoxide – Librium is a type of long-acting benzo. Long-acting benzos are often the first choice of medication treatment because they start working quickly, they last longer in the body, and they are more predictable.
  • Diazepam – Valium is another type of long-acting benzo. This medication comes in either a tablet or injection form. A single dose of Valium can last up to three days and can help reduce symptoms of anxiety, muscle spasms and insomnia.
  • Lorazepam – Ativan is a short-acting benzo that is commonly used for people who are suffering from liver damage, lung damage or over the age of 65. Short-acting benzos take longer to activate and last a shorter amount of time. This means the patient will need multiple doses. Ativan comes in tablet or injectable form and can last anywhere from 11 to 20 hours after the first administered dose.
  • Oxazepam – Serax is a short acting benzo. It comes in a daily tablet form and can take up to four hours for the patient to begin feeling the effects.

Types of Benzo medication management methods:

  • Fixed tapering dose regime (FTDR) – This method of medication management consists of fixed doses of benzos administered at scheduled intervals. Symptoms severity is not taken into consideration and a strict dosage schedule is followed.
  • Symptom-triggered regimen (STR) – In this method, benzos are administered according to the severity of withdrawal symptoms. This method helps reduce the risk of under-medicating or overmedicating a patient. Medication is only given to address the current state of well-being. A higher dose is given for more pain and a lower dose is given for less severe pain.
  • Loading dose regimen (LDR) – During this method, long-acting benzos are prescribed to reduce the risk of complications such as seizures and DT.

Reach out to Hotel California by the Sea

We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.

Many alcohol use disorder treatment programs use benzodiazepines for alcohol withdrawal symptoms. Hotel California by the Sea offers medication-assisted treatment methods that include using FDA-approved meds for alcohol withdrawal. Common benzo meds used include Valium and Ativan. Within the detox and residential treatment programs, medication management of specific benzos is utilized for patients during alcohol detox. The benzos provide a strategic and safe method for treating uncomfortable physical and psychological side effects of withdrawal. Depending on the severity of the addiction, some people can experience life-threatening withdrawal symptoms. Utilizing benzos for alcohol withdrawal is the initial first step in treatment toward long-term recovery.