If you're a heavy drinker or alcoholic planning a sudden reduction or total abstinence from alcohol, do not try to detox on your own. You will most certainly suffer alcohol withdrawal and relapse.

What is alcohol withdrawal?

Acute alcohol withdrawal is a clinical syndrome associated with the sudden reduction or total abstinence from alcohol consumption after long-term use.

According to a study that appeared in Alcohol Health and Research World Journal, researchers initially attributed AW to nutritional deficiency (a common deficiency among alcoholics brought about by poor appetite and diet) and direct intoxication. However, subsequent studies painted a different picture. In one study, well-fed men took daily doses of alcohol for three months and then abstained. They developed AW symptoms. The level of intoxication was also shown not to be the cause. It only determined the severity of the symptoms.

There is now overwhelming evidence that shows that AW symptoms are primarily caused by hyperactivity in the central nervous system (CNS). To put things into perspective, alcohol is, by nature, a depressant that lowers brain function and slacks nervous activity. When the CNS is exposed to alcohol, it reacts by raising brain and nerve function in a bid to counteract the depressive effects of alcohol. Continued exposure to alcohol leaves the CNS in a semi-permanent heightened state. The cluster of symptoms associated with this heightened CNS state is what constitutes the AW syndrome.

What are the symptoms of alcohol withdrawal?

The onset of acute AW symptoms can be as early as six hours after the last intoxication. Symptoms vary from patient to patient from the mild to the severe. With appropriate treatment, patients manifesting mild withdrawal symptoms such as nausea, insomnia, trembling, and restlessness can recover after a few days. More serious symptoms such as profuse sweating, fever (low-grade), tremor, and rapid breathing are experienced by about 10 percent of AW patients.

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In severe cases, patients may suffer from seizures and delirium tremens (DTs).

Seizures:

Withdrawal seizures have been observed to occur in more than 5 percent of untreated AW patients, with 90 percent of them commencing about 48 hours after abstinence. These seizures are characterized by spastic muscular contractions that alternate with convulsions. There is evidence that suggests that new patients with past withdrawals are more likely to experience seizures.

Delirium Tremens (DTs):

Delirium tremens is the most severe symptom of alcohol withdrawal. Statistics show that between 1 and 15 percent of DT cases will end up in death. Patients with DTs report persistent hallucinations, mental disorientation, and increased breathing and heart rate, which is occasioned by extreme hyperactivity in their autonomic nervous system (ANS). These symptoms begin to manifest between one and four days after the onset of the mild symptoms.

How should alcohol withdrawal be treated?

The aim of alcohol withdrawal treatment is to alleviate a patient's immediate discomfort or suffering, to reduce the possibility of severe symptoms, and prevent withdrawals having a snowball effect.

Common treatment regimens for AW are supportive care and pharmacological management. Supportive care identifies and treats co-occurring conditions (medical disorders that manifest alongside AW), which worsen the syndrome. These disorders can include vitamin deficiencies, liver and pancreas diseases, and infectious diseases such as TB. Supportive care alone may be enough for patients with mild withdrawal symptoms.

Pharmacological management employs drugs to treat AW. The most commonly used drugs are a class of sedatives known as benzodiazepines (BZs). BZs can treat insomnia, seizures, and anxiety. Clinicians may also use adrenergic and anti-seizure medications. BZs or antipsychotic medications are used to treat DTs.

Alcohol withdrawal is a clinical syndrome that may be very complicated to treat. It manifests in severe symptoms—some of which are life-threatening. You will have a much better chance of recovery by seeking medical help than trying to recover by yourself using alcohol detox remedies.


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