What is Meant by Withdrawal?Dear Dr. Steve:
Can
you please help me with my husband? I can’t go through this again. The last time he
tried this he almost died. My husband goes through periods where he decides he’s no
longer going to drink. To his credit, he quits cold turkey and actually doesn’t drink
for a while. But the last time he tried quitting, something went horribly wrong. I had to
rush him to the hospital. They told me that we almost lost him. He’s at that point
where he intends to quit again. I have begged him to see a doctor first and tell the
doctor what his intentions are. But he won’t listen to me. Can you give me some
information as to why he would be better off quitting under the care of a doctor than
quitting by himself?
When
somebody quits drinking after heavy consumption of alcohol over a long period of time,
they are vulnerable to experiencing alcohol withdrawal syndrome. Alcohol withdrawal
syndrome is a set of symptoms (click here for detailed list of symptoms) that
people experience when they suddenly stop drinking after using alcohol for a long time.
Symptoms of alcohol withdrawal syndrome include tremulousness, seizures, and
hallucinations. Other signs of withdrawal include getting hot, sweaty and flushed, and
developing nausea with or without vomiting. When an individual experiences simple
withdrawal, they may have a rapid heart beat (sometimes 100 beats per minute or more),
elevated blood pressure, and/or may run a temperature. They may look like someone who has
the flu. These symptoms typically present themselves within 6-48 hours after the last
drink.
More
serious symptoms referred to as delirium tremens (DTs), involve profound DTs can be very
serious if not treated by a doctor.
A second
withdrawal syndrome is known as withdrawal delirium. Withdrawal delirium is also
known as delirium tremens or D.T.’s. You can think of delirium tremens
as an exaggerated form of simple withdrawal. An individual who is experiencing withdrawal
delirium gets physically sick as described above but will also become confused and
disoriented. Confusion, hallucinations, and severe autonomic nervous system overactivity
are the hallmark symptoms of withdrawal delirium. These symptoms typically begin between
48 and 96 hours after the last drink, if they present themselves at all.
Alcohol
withdrawal delirium is a potentially life-threatening medical emergency. If your husband
indeed has a history of withdrawal delirium, he is vulnerable to re-experiencing
withdrawal delirium the next time he attempts to quit drinking. Insist on your husband
being evaluated by a qualified physician before he attempts to quit drinking.
One more
symptom of alcohol withdrawal that is potentially life-threatening is a seizure. Any
chronic consumer of larger quantities of alcohol who attempts to quit drinking is at risk
for experiencing a seizure. For those individuals who have previously experienced a
seizure or who have previously suffered a head injury are at even higher risk for
experiencing a seizure. This is just one more reason why your husband should consult his
doctor before attempting to quit drinking without medical monitoring.
Your
husband’s doctor needs to know: 1.) Your husband has a drinking problem (if he
doesn’t already know), 2.) Your husband experienced a near fatal episode the last
time your husband tried quitting (if he doesn’t already know), 3.) The current
overall physical well-being of your husband so as to decide whether to medically detox
your husband on an inpatient or outpatient basis, 4.) Your husband’s doctor needs to
decide how closely your husband needs to be monitored as he withdraws from having alcohol
in his blood system.
The goals
of treatment are to treat the immediate withdrawal symptoms, to prevent complications, and
to begin long-term preventive treatment. Immediate treatment involves symptom relief,
constant observation, and frequent monitoring of physical functions and condition.
Hospitalization is often required. Heart function, respiratory function, and general
physical condition are monitored by frequent measurements of vital signs (temperature,
pulse, rate of breathing, blood pressure) and fluids and electrolytes (chemicals in the
body such as sodium and potassium).
Symptoms may progress rapidly and become an emergency condition. Central nervous system
depressants and sedatives may be required, often in moderately large doses, to reduce
symptoms. Treatment may require maintenance of a moderately sedated state for a week or
more until withdrawal is complete. Benzodiazepine medications such as diazepam are often
useful to reduce symptoms. Clonidine may reduce cardiovascular symptoms and helps reduce
anxiety (this medication is commonly used for symptoms of narcotic drug withdrawal).
Because
your husband has gone through withdrawal a number of times without getting the right
treatment, he is at risk for his symptoms to get worse. Because of the near fatal outcome
of his last withdrawal, it’s more important than ever that he see his doctor before
he attempts to quit drinking again. You didn’t mention whether he has any other
existing medical conditions, but if he does have an existing medical condition(s) such as
infections, heart, lung, liver and/or kidney disease, and/or a history of seizure,
it’s critical that your husband see a doctor.
You too
have a role in the management of your husband’s withdrawal. If it is decided to detox
your husband on an outpatient basis, it’s helpful that he have a quiet, safe place to
stay until the withdrawal is over. As you may already know, as your husband withdraws from
alcohol, his urge to drink may become very strong. Being in a safe supportive environment
can make all the difference in then world if he develops a strong desire to drink. Once
the withdrawal symptoms go away, it's important that your husband take advantage of his
quitting and enroll in a treatment program or start attending a support group such as A.A.
Learn
how to prevent and recover from chemical dependency as well as the aftereffects of
chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of
Recovery books—From
Insanity to Serenity.
Pathfinder’s
Checklist
1.)
People who consume large quantities of alcohol over a long period of time are at risk for
experiencing alcohol withdrawal syndrome if and when they decide to quit drinking.
2.) People can experience mild discomfort such as nausea or potentially fatal symptoms
such as a seizure.
3.) Anybody who has consumed large quantities of alcohol over a long period of time should
consult a doctor before attempting to quit drinking.
4.) A doctor can manage the symptoms of alcohol withdrawal syndrome through the use of
medications.
G.B.U.
Steve
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