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Treatment of withdrawal symptoms

Published 15 July 2016.

Quitting alcohol consumption after long, regular use will cause a body’s withdrawal state that is stronger than a hangover. The various withdrawal symptoms from alcohol are normally rated from mild to moderate and strong. The mildest withdrawal symptoms will ease within a few days, while strong and untreated withdrawal symptoms may be life-threatening.

Withdrawal symptoms are caused by regular alcohol consumption, as the nervous system becomes used to alcohol’s presence in the body and, when alcohol leaves the body, the nervous system will go into a state of hyperresponsiveness. The gradually strengthening withdrawal symptoms will start to appear about 12 hours after alcohol consumption has ended. For some people, the blood alcohol content may still be clearly elevated at the time, up to 1 or 2 per mils. If untreated, withdrawal symptoms have the tendency to grow stronger so that the condition of the person suffering from these symptoms will become dramatically poorer within a few days. Therefore, it is important to be proactive about withdrawal symptoms and treat the condition properly, for example by seeking treatment at a health station or hospital.

The most commonly experienced and observed withdrawal symptoms are anxiety, sleeping troubles, restlessness, incoherency, shaking, sweating, rise of body temperature, nausea and various sensory and balance issues. As a consequence of these, strong rise of blood pressure and accelerated pulse are also often observed. Strong withdrawal symptoms may also include visual and auditory delusions, psychotic symptoms, unconsciousness and convulsions (‘booze cramps’). In addition to an interview, CIWA-Ar scale (Clinical Institute Withdrawal Assessment for Alcohol) is also one assessment method used by the healthcare services.

Withdrawal symptoms may sometimes be alleviated by decreasing alcohol consumption gradually, thus helping the body to adapt to the new situation. With regard to mild withdrawal symptoms, alcohol consumption should definitely be avoided completely (‘pick-me-ups’) as well as the use of medication (especially sleeping medication and sedatives) Best form of self-treatment is rest, as physical strain may expose to arrhythmia, for example. Hydration and nutrition are also important parts of self-treatment as well as over-the-counter medication for e.g. pain management. Usually, patients start to feel better in a few days.

If self-treatment is not sufficient or does not succeed, help for treating the withdrawal symptoms can be sought from health stations, emergency departments, A-Clinic or Substance Abuse Clinic. Based on experiences, some may see seeking treatment as shameful. However, in order to ensure proper assessment and care, professionals need the correct information about alcohol and drug use so that unnecessary examinations and even wrong diagnoses can be avoided.

After this, the detoxification treatment can be carried out as out-patient detoxification, where medicinal treatment and monitoring is carried out as appointments during the few following days. In extreme situations, detoxification can be carried out at the inpatient ward or even at a supervised hospital ward, where treatment is more intensive. At a hospital or at a detoxification ward, the medicinal treatment usually includes the use of benzodiazepines for alleviating withdrawal symptoms and prevent seizures as well as injected B1 vitamin that prevents brain damage (deficiency). These kinds of treatment periods usually last for a few days. More long-term treatment periods are usually related to underlying illnesses or simultaneous use or abuse of central nervous system depressants.

Withdrawal symptoms are always a strong indicator of alcohol addiction, which is why it is highly important to find a solution for excessive alcohol consumption and for controlling it. After the withdrawal symptoms have been treated, it is recommended to seek out situational evaluation and request the support and services needed for the situation.

Petri Kylmänen
Master of Health Care, nursing; Coordinator of substance abuse treatment
Special services of psychiatry and substance abuse, City of Helsinki

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