Alcohol Withdrawal Medication and Treatment
Those trying to quit drinking may go through alcohol withdrawal, which is a series of often unpleasant and sometimes life-threatening symptoms.
Alcohol withdrawal can involve anxiety, changes in appetite and sleep, increased heart rate, blood pressure, and body temperature, seizures, delirium tremens, a state of severe confusion, shaking, and sensory distortions1 As a result detoxing from alcohol cold turkey can result in dangerous complications and even death.1 Detox programs and medications are available to ensure detoxing from alcohol is safe.
Detox is the first step in the recovery process when trying to quit alcohol. Detox allows the body to rid itself of the immediate influence of alcohol, but it does not address the reasons that a person drinks problematically. Following detox with some form of treatment can help increase the chances of making a full recovery.
Types of programs include detox centers, inpatient rehab programs, and outpatient rehab programs. Medications that may be used during alcohol withdrawal include benzodiazepines, anticonvulsants, barbiturates, and beta-blockers.
Treatment Options for Alcohol Withdrawal
Alcohol withdrawal treatment may take place in a variety of settings.
- Detox centers are programs focused on helping people safely withdraw from alcohol. Detox program goals include monitoring and treating withdrawal symptoms, preventing dangerous symptoms, and helping people transition to the next phase of recovery. The programs offer 24-hour care from medical and mental health professionals.
- Inpatient treatment programs offer individual, group, and family therapy along with temporary living arrangements. Some inpatient programs offer help with alcohol detox, while others may provide treatment after a person has completed detox in another facility.
- Outpatient treatment programs offer therapy for several hours per week without housing or 24-hour supervision. Some outpatient programs offer detox for people with mild alcohol withdrawal who have no preexisting physical or mental health conditions and a supportive person to monitor symptoms.2 However, in many cases alcohol withdrawal carries significant risks that are most safely monitored in an inpatient program.
Recovering from alcohol addiction involves more than detox. Alcohol withdrawal is often followed by cravings, changes in mood, and physical and emotional discomfort. Seeking treatment after detox can increase the likelihood of a full recovery.
Medications may be used to treat specific alcohol withdrawal symptoms.1,2
- Benzodiazepines such as Valium (diazepam) and chlordiazepoxide can reduce the risk of serious withdrawal symptoms such as seizures. Benzodiazepines are often prescribed and then gradually tapered over a period of four to seven days to prevent a person from becoming dependent on them.
- Barbiturates such as phenobarbital may be used during alcohol withdrawal to prevent seizures and delirium. Barbiturates are often prescribed with caution since they may increase the risk for addiction, respiratory depression, and death.
- Anticonvulsants such as carbamazepine and valproic acid and may be prescribed to prevent seizures and ease other withdrawal symptoms.
- Clonidine, an alpha adrenergic agonist, and beta blockers such as propranolol may be prescribed for withdrawal symptoms such as rapid heart rate and high blood pressure. However, these drugs do not reduce the risk of seizures or delirium.
Medications may also be used to reduce cravings and the risk of a relapse after alcohol withdrawal is complete.3
- Campral (acamprosate) helps reduce the long-term symptoms of withdrawal such as anxiety, depression, and sleeping problems.
- Naltrexone is available as a pill or an injection and works by blocking the rewarding effects of alcohol.
- Antabuse (disulfiram) causes an unpleasant reaction when combined with alcohol. Taking disulfiram daily or in high-risk situations can deter people from drinking.
Tapering Off Alcohol
Abruptly quitting alcohol can cause dangerous withdrawal symptoms, including seizures, delirium tremens, and death.1 Though slowly tapering off alcohol may appear safer, trying to quit alcohol without professional help is not recommended because of the risk for medical complications and death.
The course of alcohol withdrawal can be difficult to predict because the symptoms can be unpredictable and vary significantly from person to person.1
The safest way to quit drinking is to seek professional help. Abruptly quitting or tapering on your own increases the risk of dangers.
Detoxing Cold Turkey at Home
Detoxing at home increases the risk of relapse and medical problems. Some people with less severe alcohol problems may experience mild withdrawal symptoms such as anxiety, sleeping problems, and low appetite.1 These symptoms may pose no danger and go away on their own after a few days.
However, people with more severe alcohol problems and those with a significant history of alcohol abuse and previous experiences with withdrawal are at a higher risk for medical complications during withdrawal symptoms. These symptoms can include:1
- Extreme confusion
- Heart problems
Detoxing cold turkey can also increase the risk of a relapse. Even people with a strong desire to quit drinking may give in to cravings when faced with uncomfortable withdrawal symptoms.
Detoxing in a treatment program offers the benefit of professional staff with medical and psychiatric training who can monitor and treat withdrawal symptoms, prevent complications, and help with the transition to the next phase of recovery.
. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
. Kosten, T. R., & O’Connor, P. G. (2003). Management of drug and alcohol withdrawal. New England Journal of Medicine, 348(18), 1786-1795.
. National Institute on Drug Abuse. (2012). Principles of drug addiction treatment: A research-based guide. NIH Publication Number 12-4180.