Alcohol Withdrawal Syndrome: Medications & Treatment

If you have alcohol use disorder (AUD), alcohol detox is often the first step toward better health. 

During detox, alcohol is processed out of your body, and you may experience mild to severe withdrawal symptoms. While these symptoms often ease after the first couple weeks, the overall timeline depends on the severity of your dependence on alcohol.

Getting through withdrawal is not something to do on your own. It is a complex time that people experience with varying intensity levels. Symptoms of withdrawal can change rapidly, and in cases of severe alcohol dependence, withdrawal can be a potentially dangerous process. 

As a result, medical detox is recommended for safety. When you detox with the care and support of medical professionals, they can help you manage the experience with medications and other treatments.

By working together with a medical professional in a recovery setting, you can focus on getting better and moving forward in your life.

Medications for Alcohol Withdrawal 

Various medications may be used to reduce uncomfortable symptoms during detox from alcohol. These medications can help to balance an individual’s biochemistry and reduce the risk of complications. 

Typically, medications for alcohol withdrawal include benzodiazepines, naltrexone, acamprosate, and disulfiram. 

Benzodiazepines

These drugs are commonly called benzos, and they are frequently used to manage withdrawal symptoms. They are often a top choice for alcohol withdrawal to soothe nerves and calm the central nervous system. Benzos may help to reduce muscle spasms and improve sleep quality as well. 

Some benzos are short-acting, and some are long-acting. Long-acting benzodiazepines such as Valium and Librium are generally used for alcohol detox. 

Naltrexone

This is a medication that helps to reduce cravings for alcohol. It is usually not recommended until after the first 7-10 days of detox, as it can stimulate symptoms of withdrawal. 

Naltrexone is available as a pill and as an injectable. Brand names of the pill form include ReVia and Depade. Vivitrol is the injectable form.

Acamprosate

Alcohol changes brain chemistry and functioning. This medication is typically prescribed to help the brain regain normal functioning, and it can help to reduce cravings for alcohol. It is sold under the brand name Campral.

Disulfiram

This medication produces negative effects if alcohol is consumed. The rationale is that this will encourage the individual to discontinue drinking. The negative effects include nausea, headaches, weakness, and low blood pressure.

It is important to work with your provider to understand how any medication is working in your body. Your care team will monitor its effectiveness, note any side effects, and adjust treatments as needed.

Why Medications for Alcohol Detox Matter

Alcohol is a depressant, and you may have been relying on it for months, years, or decades. During that time, your brain and biochemistry became dependent on alcohol. When you stop drinking, it takes a period of time for your body to adjust to its absence. 

This period is what is commonly called withdrawal. During withdrawal, you may have a mixture of symptoms that can range from mild to severe. The symptoms may be physical as well as psychological. 

For some people, withdrawal is not a huge deal. For others, it is extremely severe and painful. It can even be life-threatening.

Treatment professionals are skilled at helping you manage pain and focus on your recovery process. They can ensure you stay safe and are able to focus on therapy during this time.

How Alcohol Detox Works 

Alcohol withdrawal symptoms are different for each individual. They can change quickly and often catch people off guard if they are not familiar with the stages of alcohol detox. Due to this, it is important to work with a medical treatment provider who can guide you through the process.

During the first 24 hours after taking a drink, there are generally mild symptoms. These may include headaches, loss of appetite, nausea, irritability, restlessness, and difficulty sleeping. 

More severe symptoms can include seizures, hallucinations, and tremors. 

A condition called delirium tremens can include several symptoms, such as increased heart rate, elevated blood pressure, and breathing problems. Hand tremors known as the shakes may increase. A person experiencing this may feel extremely disoriented and uncontrollably restless.

It is estimated that 5 to 10 percent of people experience seizures during withdrawal. If these seizures are not properly treated, one in three of these people will continue to experience more severe symptoms associated with delirium tremens.

A seizure during withdrawal could result in permanent injury or even death. To avoid this, it is essential to seek medical support that may include the use of medications to manage withdrawal symptoms. 

Even after serious withdrawal symptoms have subsided, some people develop PAWS or post-acute withdrawal syndrome. This syndrome can include low energy, anxiousness, and difficulty sleeping. These symptoms may continue for several months or longer.

Again, medical assistance can help to effectively treat PAWS. Alcohol withdrawal doesn’t have to be painful. With the right support, you can effectively get through it with minimal discomfort.  

Why Attempting Alcohol Detox at Home Isn’t a Good Idea

While it may be tempting to detox from alcohol at home, it is not a good idea. You need medical support to ensure your safety and reduce the likelihood of relapse.

If you suddenly stop drinking, it can trigger severe withdrawal symptoms. If delirium tremens occur, the results can be incredibly serious, even deadly. It isn’t worth the risk to attempt this on your own at home.

With medical detox, you’ll be supported in a medical setting. You will likely receive medications to stabilize the withdrawal process, preventing severe withdrawal symptoms and ensuring your safety throughout the process. 

Relapse to alcohol use is also much more likely if you attempt to detox on your own. When withdrawal symptoms set in and you experience cravings for alcohol, you’re likely to simply drink again to make these negative effects disappear. With medical detox, you’ll have support to help you continue with the withdrawal process.

How to Know When You Need Help With Alcohol Withdrawal

If you or someone you love is struggling with alcohol, you can use the CAGE substance abuse screening tool to get a sense of the severity of the problem. 

The CAGE survey involves four screening questions that can help you determine if you should seek help:

• Have you ever felt you should reduce how much you drink?
• Have you felt irritated if people criticize or comment on your drinking?
• Have you ever felt guilty about drinking?
• Have you ever drank first thing in the morning?

If you answer “yes” to one or more of the questions, it is an indication that you may have an alcohol abuse issue. Talk to a treatment provider or your doctor about the place alcohol has in your life and how best to proceed toward a healthier future. 

If you have a history of chronic and high levels of alcohol abuse, you need medical support during alcohol withdrawal. Talk to a professional to determine what is appropriate for your situation.