Treatment for Alcohol Withdrawal
The main goals of treatment of alcohol withdrawal are:
- Safety
- Relapse prevention during detox
- Seizure prevention
- Proper hydration and nutrition
- Medical management of complications, such as DTs or seizures
- Symptom relief (especially nausea, insomnia, hallucinations, anxiety, etc.)
Treatment for alcohol withdrawal also includes administration of vitamin B1, also known as thiamine, either through an intravenous or oral route. This therapy is to treat any undetected Wernicke encephalopathy (sometimes referred to as “wet brain”) effects that may have developed in the individuals.
Medical Detox
Medical detox is the safest and most comfortable way to withdraw and detoxify from alcohol use. Detox usually happens in a rehab setting that provides a safe place to get through the detox process without any distractions or temptations from the outside world, and with constant supervision from medical professionals in case of any complications.
Medical detox allows for the provision of the medications and support needed to prevent seizures and other potential complications and to treat uncomfortable symptoms. For people who are vomiting, intravenous fluids and medications can be provided, which can result in a remarkable improvement in symptoms and complications.
Medical detox also allows for recovery planning, as simply detoxing from alcohol use does not constitute treatment for AUD.
Related Topic: Alcohol Detox
Medication-Assisted Treatment
Medication-assisted treatment consists of medications used to help people through detox, or to improve their chances of successful recovery after detox by reducing cravings and helping to prevent relapse.
Several medications are useful in helping some people to detox from alcohol use:
- Benzodiazepines: for seizure prevention, sedation and reducing agitation and anxiety
- Heart and blood pressure medications (such as beta blockers or clonidine)
- Anti-seizure medications
- Muscle relaxants
- Thiamine and magnesium: to treat nutritional deficiencies associated with alcohol use that can have serious medical consequences
Other medications are sometimes used, starting during or shortly after detox, but are meant to help with relapse prevention and not with withdrawal or detox specifically:
Related topic: Ativan for alcohol withdrawal
Detoxing at Home
Detoxing from alcohol at home is generally not safe. There is no test or formula that can predict the severity of withdrawal (although attempts are being made to do so), so detox is unpredictable.
However, if people are considering self-detoxing, they should consider doing so only if certain conditions are in place:
- They consult their physician first
- Their alcohol use was not heavy or prolonged
- They do not live alone, and there are people there who know that they are detoxing
- They have a safe and alcohol-free home
- There is help available if they develop serious complications, such as DTs or seizures, and can’t help themselves
One of the hallmark psychological characteristics of alcohol use disorder is that people maintain a persistent need for control and remain convinced that they can handle their addiction on their own, even after multiple failures to do so. As such, people with AUD may be wise to consult their physician and loved ones when they decide that they want to self-detox.
When people develop seizures or DTs, they can’t help themselves, so having capable and informed help nearby is essential.
Related Topic: Vitamins for alcohol detox