Treating alcohol withdrawal with benzodiazepines – Safe if mindful
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Contributing co-author: Andrew Chen
Alcohol withdrawal can be extremely unpleasant (see here for an overview). Symptoms vary from person to person, but most people will experience some negative symptoms of alcohol withdrawal if they try to stop drinking after long term use.
Mild to moderate symptoms include headache, nausea, vomiting, insomnia, rapid heart rate, abnormal movements, anxiety, depression, and fatigue. Severe symptoms of alcohol withdrawal include hallucinations, fever, and convulsions (known as DT’s or delirium tremens). Most people undergoing alcohol detox do not require hospitalization, but in severe cases, hospitalization may be necessary (1). Since their introduction in the 1960s, benzodiazepines have been the drug of choice for treating severe cases of alcohol withdrawal.
Benzodiazepines, or benzos for short, are a class of psychoactive drugs that work to slow down the central nervous system by activating GABA receptors. This provides a variety of useful tranquilizing effects. Aside from relieving symptoms of alcohol withdrawal, benzodiazepines are also commonly prescribed to treat insomnia, muscle spasms, involuntary movement disorders, anxiety disorders, and convulsive disorders.
The most common regimen for treating alcohol withdrawal includes 3 days of long-acting benzodiazepines on a fixed schedule with additional medication available “as needed.” (2)
The two most commonly prescribed benzos are chlordiazepoxide and diazepam. Chlordiazepoxide (Librium) is preferred for its superior anticonvulsant capabilities while diazepam (Valium) is preferred for its safety against overdose with alcohol. Short-acting benzos like oxazepam and lorazepam are less frequently used for treating alcohol withdrawal (1).
Compared to other drugs, benzos are the safest and most effective method for treating difficult alcohol withdrawal. However, benzodiazepines do come with their own potential for dependence and abuse. Ironically, symptoms of benzodiazepine withdrawal are quite similar to those of alcohol withdrawal. Tapering off dosage is the best way to prevent serious withdrawal symptoms. To avoid such complications, benzodiazepines are only recommended for short-term treatment of alcohol withdrawal.
In short
Benzos can be very useful for helping long terms alcoholics deal with the difficult withdrawal symptoms that can accompany the detox period. Just be mindful so as not to find yourself right back where you started.
Citations:
1. Williams, D., McBride, A. (1998) The drug treatment of alcohol withdrawal symptoms: A systematic review. Alcohol & Alcoholism. 33(2), 103-115
2. Saitz, R., Friedmn, L. S., Mayo-Smith, M.F. (1996) Alcohol withdrawal: a nationwide survey of inpatient treatment practices. 10(9), 479-87
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Tags: Alcohol, benzo, delirium, depression, detox, dt, med, nausea, rehab, treatment, tremens, withdrawal
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5 Responses to “Treating alcohol withdrawal with benzodiazepines – Safe if mindful”
Is it true that you can actually die from alcohol withdrawls but not die from heroin withdrawls? It seems like it would be the other way around, but i am probably wrong.
By free alcohol treatment on Apr 26, 2009
It is certainly true that long term, heavy, alcohol use can lead to withdrawal symptoms that are deadly if not medically supervised. On the other hand, while heroin withdrawal can be harrowing, withdrawal from heroin alone is rarely deadly.
Keep in mind that withdrawal from other opiates, such as methadone, can in fact be deadlier than withdrawal from heroin itself. This is often one of the reasons people cite against methadone’s use in addiction treatment.
By Adi Jaffe on Apr 28, 2009
If you are an alcohol addict, then letting go that addiction is not that easy. There are many reasons for it and one of them is alcohol withdrawal symptoms which happen to people who suddenly leave alcohol.With the proper medical care, alcohol withdrawal symptoms can be greatly reduced or even eliminated. There are specific treatments available at many alcohol addiction treatment centers for anyone who wants to stop drinking, even after long-term, chronic alcohol abuse.
By Crum on Jan 15, 2010
withdrawl from narcotics is horrible. It takes several days and excites every unpleasant thing in your body nerves and stomach are worst. For me swithching to a drug that was being prescibed did not help much with the physical I still got just as high. But the process of going to a dr’s made me feel less guilty and was able to physically wean off narcotics. mentally i was not used to all the feelings and sensory overloads of day to day living. I started drinking extremly heavely after one month of getting off narcotics. Two years later the withdral from alcohol is not so much the physical pain (could not move, sleep or eat, throwing up constantly, extreme head and body aches). but alcohol withdrawl is severe panic attackes physiacal pain but mostly mental. Both are extreme hell and cant wait for it to all be out of my system! Should have listened dont do drugs
By tonya on Feb 12, 2010