Medical Treatment for Alcohol Withdrawal Symptoms

Common Medications Used in a Drug and Alcohol Detox

Medical Treatment for Alcohol Withdrawal Symptoms

Individuals suffering from addiction are often fearful of entering detox due to the typical discomfort associated with withdrawals from drugs and alcohol. While withdrawal symptoms are often considered physical, many substances also can be associated with difficult mental health and psychiatric issues during withdrawal.

Fortunately, there are many FDA-approved medications that are safe and effective in getting people detoxed and through withdrawals in a comfortable way.

Each individual who enters detox, depending on their medical history and what substances they are using, will be seen, assessed, and evaluated by a doctor and then put on a clinically appropriate detox protocol of medications that will help treat their symptoms.

Every patient should also be evaluated by a psychiatrist, who can make sure they are properly assessed for any mental health or psychiatric issues, and prescribed medications to ensure mental health and psychiatric issues are appropriately managed through detox and the withdrawal process.

Acamprosate

Acamprosate (brand name: Campral) is a medication approved by the FDA in the treatment for alcoholism.  It is one of three approved medications to treat alcohol use disorder by the FDA and reduces the brain’s dependence on alcohol by reacting with the brain’s neurotransmitter systems.

Antiadrenergic agents

Antiadrenegic agents are drugs that inhibit the signals of epinephrine and norepinephrine. Some examples of these types of drugs are clonidine and propranolol. These medications are often used during detox to help treat the withdrawal symptoms from alcohol, opiates, and benzodiazepines.

Anticonvulsants

Some examples of anticonvulsant drugs used during a detox stay to help manage symptoms or side effects from drug and alcohol withdrawals are Depakote or Tegretol. Other examples of anticonvulsants are phenobarbital, levetiracetam (Keppra), and clonazepam (Klonopin.) Anticonvulsants work in different ways depending on the specific drug to prevent seizures.

Antidepressants

Antidepressants are types of medication that help relieve symptoms of depression, social anxiety, other types of anxiety disorders, as well as several other disorders. These drugs aim to correct chemical imbalances in the brain of neurotransmitters that are responsible for changes in mood and behavior. Some examples of antidepressants are Celexa, Lexapro, Prozac, Paxil, and Zoloft.

Anti-nausea medications

During detox, many patients experience withdrawal symptoms that include nausea. Therefore, in order to treat those withdrawal symptoms, doctors and nurses may prescribe anti-nausea medications. Some examples of these medicines often used in detox are Zofran, promethazine, and metoclopramide.

Antipsychotics

For those patients in detox that have certain co-occurring or psychiatric issues, a doctor or nurse at the detox may prescribe them an antipsychotic medication. Antipsychotic medications can be used to help treat schizophrenia, bipolar disorders, dementia, and other psychiatric issues.

These medications don’t cure psychosis, but they can help in reducing and controlling many psychotic symptoms, such as delusions, hallucinations, paranoia, and hearing voices. Sometimes they can also help treat withdrawal symptoms such as anxiety and major agitation in patients.

Some examples of antipsychotics used in a detox setting for drugs and alcohol include olanzapine, Risperdal, Seroquel, Abilify, and Clozaril.

Benzodiazepines

Benzodiazepines are a type of medication, known as tranquilizers, commonly used for their sedating effects and to often prescribed to treat anxiety, panic disorders, panic attacks, seizures, and insomnia, or trouble sleeping.

Common examples of benzodiazepines are Ativan (lorazepam), chlordiazepoxide, diazepam, Librium, Valium, and Xanax. They are often used in several types of drug detox.

However, because benzodiazepines are often addicting and many people seek drug detox and treatment for benzodiazepine addiction, they need to be carefully used and monitored during detox.

For individuals that do not have a history of benzodiazepine addiction, these medications can be extremely helpful through detox. For those that do have a history or current active misuse of benzodiazepines, these medications can be used during detox but should be closely monitored.

Buprenorphine

Used primarily in detox from opioids or opiates, buprenorphine is an opioid partial agonist approved by the FDA to treat opioid use disorder and addiction. It can be used in a detox setting or prescribed as part of a Medication-Assisted Treatment (MAT) protocol.

Buprenorphine is a safe and effective medication that helps to diminish the effects of physical dependency on opioids, such as reducing withdrawal symptoms and cravings, increases safety in cases of potential overdose, and lowers the potential for misuse.

Buprenorphine can be prescribed directly or as part of similar branded medications in different formulations, such as in sublingual tablets called Subutex, a combination of buprenorphine and naloxone sublingual tablets called Zubsolv, or as an extended-release injection called Sublocade.

Disulfiram

Often used during detox to treat alcohol use disorder or alcoholism, Disulfiram is a medication that interferes with how the body breaks down alcohol.

It is manufactured and designed to produce a negative and/or unpleasant physical effect if combined with alcohol, meaning that when combined with alcohol this medication produces an acute sensitivity to the ethanol. Disulfiram is sold under the trade name Antabuse.

Methadone

Used to treat opioid use disorder and opioid addiction, methadone is a medication that is often used in Medication-Assisted Treatment (MAT) programs but can also be used to both help detox someone that is coming off methadone or as a short-term detox protocol for opioid misuse and abuse. Methadone is a long-acting opioid agonist that reduces opioid cravings and withdrawal symptoms.

Modafinil

The medication Modafinil is typically used to treat excessive sleepiness caused by narcolepsy and other sleep disorders. Prescribed to help prevent excessive sleepiness or tiredness, Modafinil is a wakefulness-promoting agent that works by changing the amounts of certain natural substances in the brain that control sleep and wakefulness.

Naltrexone

The medication naltrexone is often used in a medical detox and treatment for those individuals suffering from alcohol use disorder, alcoholism, opioid use disorder, or opioid addiction.

It is an FDA-approved medication that comes in either pill form or as an injectable. Naltrexone works by blocking the euphoric and sedative effects of painkilling substances such as heroin, morphine, fentanyl, and codeine.

This medication binds and blocks the opioid receptors in the brain and helps to reduce cravings.

Suboxone

The brand name Suboxone is a medication used in the treatment of opioid addiction.

It is delivered via a sublingual tablet that dissolves under the tongue or as a sublingual film that dissolves under the tongue or inside the cheek. Suboxone is a combination of two drugs, buprenorphine and naloxone.

It helps to lessen the intensity of withdrawal symptoms from drugs heroin, OxyContin, Percocet or other opioid and opiate drugs.

Subutex

Subutex is a sublingual tablet that contains the medication buprenorphine and is a partial opioid agonist that operates at the mu-opioid receptor. It typically comes in two dosage strengths, 2 mg and 8 mg. Subutex is a medication indicated for the treatment of opioid dependence, opioid use disorder, and opioid addiction.

Vivitrol

Vivitrol is a type of medication that utilizes naltrexone in an extended-release injectable suspension. Naltrexone binds to the endorphin receptors in the body and blocks the feelings and effects of both opioids and alcohol. This medication helps reduce cravings and thoughts regarding the use of opioids and alcohol.

If you or someone you know needs help for addiction or co-occurring disorders, please give us a call. Innovo Detox offers the latest in evidence-based medical, psychiatric, and clinical care for those in need of detox and medical stabilization in Pennsylvania and the surrounding Mid-Atlantic area.

If we aren’t the best fit for you or a loved one, we will take the necessary time to work with you to find a detox, rehab, treatment center or provider that better fits your needs. Please give us a call at (717) 619-3260 or email our team at info@innovodetox.com.

For more information on our company or services, please visit our website at www.innovodetox.com.

Источник: https://www.innovodetox.com/2021/04/26/common-medications-used-drug-alcohol-detox/

Alcohol misuse — Treatment

Medical Treatment for Alcohol Withdrawal Symptoms

The treatment options for alcohol misuse depend on the extent of your drinking and whether you're trying to drink less (moderation) or give up drinking completely (abstinence).

If you are worried about your drinking or have had an alcohol-related accident or injury, you may be offered a short counselling session known as a brief intervention.

A brief intervention lasts about 5 to 10 minutes, and covers risks associated with your pattern of drinking, advice about reducing the amount you drink, alcohol support networks available to you, and any emotional issues around your drinking.

Keeping a «drinking diary» may be recommended so you can record how many units of alcohol you drink a week. You may also be given tips about social drinking, such as alternating soft drinks with alcoholic drinks when you're out with friends.

Moderation or abstinence are treatment options if you're:

  • regularly drinking more than 14 units a week
  • experiencing health problems directly related to alcohol
  • unable to function without alcohol (alcohol dependency)

Cutting alcohol out completely will have a greater health benefit. However, moderation is often a more realistic goal, or at least a first step on the way to abstinence.

Ultimately, the choice is yours, but there are circumstances where abstinence is strongly recommended, including if you:

  • have liver damage, such as liver disease or cirrhosis
  • have other medical problems, such as heart disease, that can be made worse by drinking
  • are taking medication that can react badly with alcohol, such as antipsychotics
  • are pregnant or planning to become pregnant

Abstinence may also be recommended if you've previously been unsuccessful with moderation.

If you choose moderation, you'll probably be asked to attend further counselling sessions so your progress can be assessed, and further treatment and advice can be provided if needed.

You may also have regular blood tests so the health of your liver can be carefully monitored.

If you're dependent on alcohol to function, it's recommended you seek medical advice to manage your withdrawal.

Some people may be prescribed medication to help achieve abstinence. You may also choose to attend self-help groups, receive extended counselling, or use a talking therapy such as cognitive behavioural therapy (CBT).

Where detox is carried out

How and where you attempt detoxification will be determined by your level of alcohol dependency. In mild cases, you should be able to detox at home without the use of medication as your withdrawal symptoms should also be mild.

If your consumption of alcohol is high (more than 20 units a day) or you've previously experienced withdrawal symptoms, you may also be able to detox at home with medication to help ease withdrawal symptoms. A tranquiliser called chlordiazepoxide is usually used for this purpose.

If your dependency is severe, you may need to go to a hospital or clinic to detox. This is because the withdrawal symptoms will also be severe and are ly to need specialist treatment.

Withdrawal symptoms

Your withdrawal symptoms will be at their worst for the first 48 hours. They should gradually start to improve as your body begins to adjust to being without alcohol. This usually takes 3 to 7 days from the time of your last drink.

You'll also find your sleep is disturbed. You may wake up several times during the night or have problems getting to sleep. This is to be expected, and your sleep patterns should return to normal within a month.

During detox, make sure you drink plenty of fluids (about 3 litres a day). However, avoid drinking large amounts of caffeinated drinks, including tea and coffee, because they can make your sleep problems worse and cause feelings of anxiety. Water, squash or fruit juice are better choices.

Try to eat regular meals, even if you're not feeling hungry. Your appetite will return gradually.

You must not drive if you're taking medication to help ease your withdrawal symptoms. You should also get advice about operating heavy machinery at work. You need to tell the DVLA if you have an alcohol problem – failure to do so could result in a fine of up to £1,000.

It's ly the medication will make you feel drowsy. Only take your medication as directed.

Detox can be a stressful time. Ways you can try to relieve stress include reading, listening to music, going for a walk, and taking a bath. Read more about stress management.

If you're detoxing at home, you'll regularly see a nurse or another healthcare professional. This might be at home, your GP practice, or a specialist NHS service. You'll also be given the relevant contact details for other support services should you need additional support.

Withdrawal from alcohol is an important first step to overcoming your alcohol-related problems. However, withdrawal isn't an effective treatment by itself. You'll need further treatment and support to help you in the long term.

A number of medications are recommended by the National Institute for Health and Care Excellence (NICE) to treat alcohol misuse. These include:

  • acamprosate
  • disulfiram
  • naltrexone
  • nalmefene

Nalmefene

Nalmefene (brand name Selincro) may be used to prevent a relapse or limit the amount of alcohol someone drinks.

It works by blocking opioid receptors in the brain, which reduces cravings for alcohol.

Nalmefene may be recommended as a possible treatment for alcohol dependence if you've had an initial assessment and:

  • you're still drinking more than 7.5 units a day (for men) or more than 5 units a day (for women)
  • you don't have any physical withdrawal symptoms
  • you don't need to stop drinking immediately or achieve total abstinence

Nalmefene should only be taken if you're receiving support to help you reduce your alcohol intake and continue treatment.

Many people who have alcohol dependency problems find it useful to attend self-help groups, such as Alcoholics Anonymous (AA).

One of the main beliefs behind AA is that alcoholic dependence is a long-term, progressive illness and total abstinence is the only solution.

The treatment plan promoted by AA is a 12-step programme designed to help you overcome your addiction.

The steps include admitting you're powerless over alcohol and your life has become unmanageable, admitting you've acted wrongly and, where possible, making amends with people you've harmed.

Read more about the 12 steps of Alcoholics Anonymous and alcohol support.

12-step facilitation therapy

12-step facilitation therapy is the programme devised by AA. The difference is you work through the stages on a one-to-one basis with a counsellor, rather than in a group.

The therapy may be your preferred treatment option if you feel uneasy or unwilling to discuss your problems in a group setting.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a talking therapy that uses a problem-solving approach to alcohol dependence.

The approach involves identifying unhelpful, unrealistic thoughts and beliefs that may be contributing towards your alcohol dependence, such as:

  • «I can't relax without alcohol.»
  • «My friends would find me boring if I was sober.»
  • «Just drinking one pint can't hurt.»

Once these thoughts and beliefs are identified, you'll be encouraged to base your behaviour on more realistic and helpful thoughts, such as:

  • «Lots of people have a good time without alcohol, and I can be one of them.»
  • «My friends me for my personality, not for my drinking.»
  • «I know I can't stop drinking once I start.»

CBT also helps you identify triggers that can cause you to drink, such as:

  • stress
  • social anxiety
  • being in «high-risk» environments, such as pubs, clubs and restaurants

Your CBT therapist will teach you how to avoid certain triggers and cope effectively with those that are unavoidable.

Family therapy

Alcohol dependence doesn't just impact on an individual – it can also affect a whole family. Family therapy provides family members with the opportunity to:

  • learn about the nature of alcohol dependence
  • support the member of the family who is trying to abstain from alcohol

Support is also available for family members in their own right. Living with someone who misuses alcohol can be stressful, so receiving support can often be very helpful.

There are a number of specialist alcohol services that provide help and support for the relatives and friends of people with a dependence on alcohol.

For example, Al-Anon is an organisation affiliated with AA that provides relatives and friends with help and support. Its confidential helpline number is 020 7403 0888 (10am to 10pm, 365 days a year).

Read more about the different types of talking therapies.

If you're aiming to moderate your drinking, you may be asked to keep a «drinking diary».

On a daily basis, make a note of:

This will give you a good idea of how much alcohol you're drinking, the situations in which you drink, and how you could start to cut down.

Page last reviewed: 21 August 2018
Next review due: 21 August 2021

Источник: https://www.nhs.uk/conditions/alcohol-misuse/treatment/

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