Have you ever wondered how much alcohol a person has to drink (and for how long) before he or she risks developing a withdrawal syndrome after sudden abstinence? Do you wonder which methods are best to diagnose and quantify the severity of alcohol withdrawal? If yes, keep reading.
Alcohol Withdrawal in San Diego
Are you uncertain about which strategies can best manage alcohol withdrawal?
Descriptions of alcoholism withdrawal, including delirium tremens (DTs), have filled the medical literature since the late 18th century. Decades later, alcohol withdrawal was labeled as “brain fever” secondary to “frequent and excessive intoxication.” In that same year, the syndrome was called delirium tremens. More than a century later in 1953, Fraser induced an abstinence syndrome (manifest by tremulousness, seizures, and “canine delirium”) in chronically alcohol-intoxicated canines. Our understanding of these syndromes grew when Victor and Adams used a naturalistic setting to study 206 patients hospitalized for alcoholism. After their patients’ intake of alcohol ceased upon hospitalization, 12% had seizures, 18% developed hallucinations, and 5% developed Delirium Tremens. All these symptoms were related to the cessation of alcohol consumption.
History of Alcohol Withdrawal
Over the years, a variety of treatments have been tried for symptoms of alcohol withdrawal. In the early 20th century, lumbar punctures were utilized; decades later, hydrotherapy became a common treatment, and by the mid of the century, both electroconvulsive shock therapy and insulin coma therapy were seen as choices for the treatment of alcohol withdrawal.
In 1994, Harrison’s Principles of Internal Medicine recommended adequate nutrition and diligent recognition of central nervous system (CNS) symptoms of withdrawal, with the subsequent administration of another CNS depressant (with a taper of the medication over 3–5 days). Benzodiazepines with a short half-life were recommended for patients with liver disease; however, medications with longer half-lives (chlordiazepoxide or diazepam) were generally chosen. More modern medications such as suboxone, sublocade and vivitrol have shown positive outcomes in craving and withdrawal as well.
Alcohol Withdrawal Statistics and Prevalence
At some time in their lives, 20% of men and 10% of women in most Western countries will have an alcohol-use disorder, which is defined as repetitive alcohol-related problems in at least 2 of a dozen areas of life. These conditions can decrease the life span by a decade and are associated with severe impairments in social functioning, as well as high rates of medical problems. Although alcohol-related conditions occur in persons from all social levels and affect more than 20% of patients in most medical settings, few physicians have been adequately trained in identifying and treating these serious problems. About 50% of persons with alcohol-use disorders have symptoms of alcohol withdrawal when they reduce or discontinue their alcohol consumption; in 3 to 5% of these persons, either convulsions or severe confusion (a delirium), or both develop.
Withdrawal symptoms associated with depressants such as alcohol include insomnia, anxiety, and increased pulse and respiration rates, body temperature, and blood pressure, as well as a hand tremor. Because of the short action of ethanol (beverage alcohol), withdrawal symptoms usually begin within 8 hours after blood alcohol levels decrease, peak at about 72 hours, and are markedly reduced by day 5 through 7 of abstinence. The time course of alcohol withdrawal and the severity of symptoms associated with it must be closely monitored to identify the most effective treatments.
Background Alcohol withdrawal delirium (AWD), commonly known as delirium tremens is the most serious manifestation of alcohol withdrawal syndrome. The classic clinical presentation of AWD includes hyperpyrexia, tachycardia, hypertension, and diaphoresis. The incidence of AWD averages 5% in placebo-treated alcohol dependent patients entered into clinical trials of inpatient drug treatment for alcohol withdrawal. Clinical features of alcohol withdrawal syndrome can appear within hours of the last drink, but delirium typically does not develop until 2 to 3 days after cessation of drinking. Alcohol withdrawal delirium usually lasts 48 to 3 days, but there have been case reports of much longer duration. Initial studies found mortality to be as high as 15%, but with advances in treatment, mortality rates have fallen, with more recent studies indicating mortality of 0% to 1%.
Alcohol Withdrawal Treatment
Medication assisted treatment may be used for appropriate treatment alcohol withdrawal delirium. Medications should not be used as stand alone treatment for alcohol withdrawal delirium. Antipsychotics should only be used as an adjunct to benzodiazepines in severe withdrawal delirium which has not responded to adequate doses of benzodiazepines.
Severe alcohol addiction and withdrawal symptoms like delirium tremens do not have to destroy your life any longer. La Jolla Recovery combines cutting-edge western techniques with eastern modalities at our state of the art addiction and detox center. Contact our experienced team of clinicians if any of these extremely disturbing signs of alcoholic intoxication feel familiar to you. Be aware that a loved one may have dual diagnosis such as mental health along with abusing substances such as heroin, prescriptions or cocaine.
Need help for proper alcohol withdrawal and detoxification in San Diego, California?
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