Withdrawal syndrome in alcoholism is an acute, severe condition that develops in people with stage II and III alcohol dependence several hours after taking the last dose of alcohol.
Under the influence of somatic and mental attacks, a person cannot resist the craving for alcohol and continues to drink, going on a binge and provoking the progression of addiction. This component of dependence is called physical. It is easily treated with medication and is usually stopped at the very beginning of treatment for alcoholism.
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How long does withdrawal symptoms last?
Duration depends on:
- medical history;
- medical measures taken by the patient.
Without treatment, withdrawal symptoms can last for several weeks . Severe complications may develop, which without treatment can result in death.
If the patient refuses to drink alcohol, the condition lasts up to 1-2 weeks . Then the symptoms gradually subside.
With treatment, persistent improvement occurs within 3-5 days . The main part of the ailment disappears after detoxification and symptomatic therapy.
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According to the international classification ICD-10 and the WHO definition, withdrawal has the following characteristics:
- occurs only after drinking alcohol;
- the interval between drinking alcohol and the development of alcohol withdrawal syndrome is 3-10 hours;
- symptoms reflect functional disorders of any body system;
- the condition lasts up to 7 days, but more often goes away within 48 hours.
Withdrawal occurs when the amount of alcohol in the blood decreases. Some of the ethanol is in the form of breakdown products - toxic acetaldehyde. Therefore, the patient suffers from both intoxication and a hangover.
Literature:
- Alcohol withdrawal syndrome / I.V. Bokiy, I.P. Lapin. – Leningrad: Medicine. Leningr. department, 1976. – 119 p.
- Modern approaches to the treatment of severe alcohol withdrawal syndrome (methodological recommendations) / Association of Narcologists, a professional community of narcologists; [compiled by: Vinnikova M. A and others]. – Moscow: New Terra, 2021. – 47 p.
- Detoxification in acute ethanol poisoning complicated by alcohol withdrawal syndrome or delirium delirium: abstract of thesis. ... Candidate of Medical Sciences: 03.14.04 / Vitaly Viktorovich Zaikovsky; [Place of protection: Scientific research. Institute of Emergency Medicine named after. N.V. Sklifosovsky]. – Moscow, 2011. – 26 p.
Types of alcohol withdrawal
The main classification of hangover is based on clinical manifestations.
Neurovegetative
The most common type of withdrawal causes a functional disorder of the autonomic system: dizziness, panic attacks, tremors, sweating, tachycardia. This condition is difficult to feel: the person feels as if he is having a heart attack or a mental attack. Moreover, during examination, markers of the cardiovascular system are often within normal limits.
Visceral
Symptoms in patients from this group are associated with the functioning of the digestive tract. Complaints include diarrhea, abdominal pain, nausea and vomiting. At the same time, they suffer from neurovegetative manifestations, which trigger disturbances in the gastrointestinal tract along with intoxication. A common complication of the visceral type of withdrawal is dehydration and electrolyte imbalance.
Cerebral
It provokes a painful headache reminiscent of a migraine, fainting, and epileptiform attacks.
Psychopathological
Mental disorders are expressed in depression, apathy, as well as disturbances of perception: patients can hear voices, see “little green men”, guess non-existent snakes in the outlines of shadows on the wall, claim that they are being watched, etc. This type of withdrawal syndrome is observed in chronic alcoholism.
According to the severity, withdrawal is differentiated into:
- light;
- average;
- heavy.
It is difficult to draw a line of demarcation between them: in addition to the hangover itself, the alcohol addict suffers from poisoning, complications, and exacerbations of chronic diseases.
Differences between a hangover and withdrawal symptoms
A hangover is a common name for withdrawal symptoms. However, it is important to distinguish these two conditions from each other.
In a person free from alcohol addiction, drinking large amounts of alcohol causes post-intoxication syndrome. Its manifestations are similar to withdrawal, with the exception of cravings for alcohol. At the sight and smell of alcohol, a person will feel disgust and promise himself to “never drink again.”
A hangover is a sign of alcohol addiction. Unlike post-intoxication, it is always accompanied by a strong craving for alcohol.
Development of psychological dependence
The disease develops unnoticed; often those around them realize that a person has become an alcoholic already when he has turned into a binge drunkard. Alcohol addiction develops rather slowly compared to drug addiction, and slow, minor changes do not attract attention.
There is another reason for the “sudden” transformation of a healthy person into an alcoholic. Generally accepted standards for drinking alcohol are quite capable of causing the development of alcohol dependence. Therefore, an alcoholic, already sick, finds quite decent reasons to drink. And this is quite enough to form a stable psychological and physical attachment to use.
The psyche of a person who is predisposed to the development of chemical, in particular alcohol, dependence easily finds advantages in drinking alcohol. This helps to relieve tension, feel more free in communication, get euphoria, and forget about problems. The consumption of alcoholic beverages becomes constant, and the patient develops withdrawal syndrome. This completes the first stage of the disease, and binge drinking begins.
Causes of withdrawal
The etiology of withdrawal syndrome has not yet been fully studied. But the most promising version, which the scientific community is leaning towards, is a disruption of the neurotransmitter system.
Ethanol is a psychoactive substance. It can change a person’s mood, behavior and feelings. When drinking, he feels cheerful and relaxed or peaceful: exactly how intoxication will affect the personality depends on which receptors ethanol binds to.
For example, the effect on dopamine receptors will give a feeling of euphoria, joy, high spirits and a sense of strength. When ethanol is metabolized, the condition gradually returns to normal. But if a person drinks regularly, his body reduces the production of its own dopamine, because its function is already performed by alcohol. Therefore, when sobering up, a person is faced with a lack of dopamine, which provokes:
- depression;
- apathy;
- suicidal thoughts.
To return to a euphoric state, the addict unconsciously reaches for a new dose, thereby causing the progression of the disease.
In addition to dopamine receptors, other receptors are also involved in the formation of a hangover:
- GABA;
- NMDA et al.
Therefore, the motives for drinking alcohol among addicts may differ: one needs another serving of alcohol to improve their well-being, another needs to suppress sad thoughts, and a third needs to calm down. The patient constantly increases the amount of ethanol consumed, the body's tolerance increases, so over time, even severe intoxication does not bring him pleasure.
“Happy hormone” dopamine – friend or foe?
Dopamine is a neurotransmitter in the human brain, also called the “happiness hormone,” which is responsible for connections between nerve cells. Acetaldehydes suppress the production of dopamine and accelerate its breakdown. With regular abuse of alcoholic beverages, the reserves of this neurotransmitter in the body are depleted, and it is replaced by alcohol. At the first stage of addiction, a person begins to feel the need for alcohol due to a lack of dopamine and vivid sensations, then at the second stage, the addict’s body begins to adapt to new conditions, resulting in additional synthesis of dopamine.
Due to its deficiency, an addicted person experiences increased anxiety, nervousness, irritability, increased blood pressure, and disrupted sleep patterns. If the level of this hormone in the body increases 3 times, delirium tremens occurs - “delirium tremens”.
Diagnosis of symptoms of alcohol withdrawal syndrome
The manifestations of withdrawal are similar to a number of acute mental disorders and traumatic brain injuries, therefore, to differentiate the diagnosis, the doctor specifies the following signs:
- the person has recently consumed alcohol;
- symptoms consistent with alcohol withdrawal;
- other pathologies not related to alcohol consumption were not identified.
Further diagnostic measures are related to:
- clarification of the severity of the condition;
- identifying the main risks;
- compiling an anamnesis.
The list of mandatory studies carried out after examination and questioning of the patient includes:
- general and biochemical blood test;
- urine test;
- electrocardiogram.
Additionally, the doctor prescribes:
- Wasserman reaction test, antibodies to hepatitis B and C, HIV;
- comprehensive ultrasound of the abdominal organs;
- toxicological study;
- fluorography;
- electroencephalogram;
- consultation with other specialists.
When providing assistance at home, the doctor performs a minimum of diagnostic procedures: takes an ECG, measures blood pressure and pulse, and blood sugar levels. But if there are alarming symptoms that indicate a high risk of complications, the patient is hospitalized in the clinic.
There are three degrees of severity, the data of which allows you to draw up a more accurate therapeutic plan:
1. The first degree is usually diagnosed with short-term addiction and short-term binge drinking. Complaints are limited to asthenia, autonomic imbalance and thirst.
2. The second degree of severity develops with heavy drinking for up to 1-1.5 weeks. Due to severe intoxication, a person suffers from fluctuations in blood pressure, tachycardia, and a feeling of foggy consciousness.
3. The third degree usually occurs when binge drinking lasts longer than a week and a half, and is accompanied by somatic and mental disorders and an increased risk of severe complications.
During a long-term drinking binge, a person sequentially goes through all three stages, and the rate of development depends on the state of health, genetics, and the amount and type of drink consumed.
Types of Treatment for Alcohol Withdrawal
Self-medication is the most common and ineffective approach. Taking drugs without a doctor's prescription, a person can provoke the development of severe side effects: incompatibility of drugs, allergic reactions and the effect of drugs on internal organs suffering from intoxication. In case of alcohol withdrawal, you need to consult a doctor and undergo a course of treatment.
At home, the doctor provides assistance for mild to moderate severity. When a person does not have chronic diseases and is not in serious condition. At home, you can install an IV and also give the patient a set of medications that will relieve the unpleasant symptoms of a hangover and prepare the patient for the next stage of treatment.
Therapy in a hospital is carried out at the request of the patient, as well as in the presence of objective indications. At the clinic, the patient receives round-the-clock monitoring, rapid adjustment of prescriptions if the condition worsens, as well as hardware detoxification techniques and physical therapy.
Traditional methods cannot stop withdrawal symptoms. Some recipes can reduce intoxication and also dull unpleasant symptoms due to the sedative effect of medicinal plants. However, when using decoctions and infusions, it is important to consider that the result is felt only when the active substance accumulates in the body, while many plants are toxic and can harm the liver and kidneys.
Rapid relief of alcohol withdrawal is achieved through symptomatic and supportive therapy. That is, the manifestations of the condition are muffled with medication before the body truly recovers and the craving for ethanol disappears.
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Drugs for the treatment of withdrawal symptoms in alcoholism
In drug treatment practice, an individual set of drugs is used. After detoxification, the doctor prescribes to the patient:
- tranquilizers;
- antidepressants;
- sleeping pills;
- anticonvulsants;
- vegetative stabilizing drug;
- nootropics and cerebroprotectors;
- vitamin complexes;
- antioxidants.
The drugs should be taken in courses under the supervision of doctors. Many psychotropic drugs cause withdrawal symptoms, so it is important to prevent drug cravings from developing.
Complications and possible consequences
Alcohol withdrawal is the main trigger for binge drinking. When a person drinks alcohol in large quantities, he can face any kind of disorder. The list of the most common complications includes:
- liver damage;
- cardiovascular accidents;
- impaired filtration capacity of the kidneys;
- seizures;
- mental attacks.
Another consequence of withdrawal is the progression of addiction. At the terminal stage of alcoholism, it is much more difficult to cope with the disease, and some pathological changes in health and personality are almost irreversible. If you or a loved one is struggling with alcoholism. Don't delay, seek help and start treatment.
