How Does Antabuse Work? Everything You Need to Know to Decide if Disulfiram Antabuse Treatment is Right For You

Antabuse (Disulfiram is the generic name) is a medication given to people who are struggling with alcohol addiction and need medication to support their efforts to abstain. Breaking the cycle of addiction is extremely difficult and sometimes a person needs to medically remove alcohol as an option in order to begin to recover. Disulfiram Antabuse treatment is not a cure for addiction. It discourages drinking due to the extremely unpleasant consequences (the disulfiram reaction) that happen when Antabuse and alcohol are combined. How does Antabuse work? In order to understand this, we need to take a look at how alcohol is metabolized. Antabuse interferes with this pathway and this is why you get sick if you drink alcohol while taking Antabuse.



Wondering if you have a drinking problem or at risk for withdrawal? Take a moment now to read these posts:  Do you have a drinking problem? and Alcohol Dependence and Withdrawal: Are You at Risk?

Antabuse Treatment: How alcohol is broken down

Disulfiram Antabuse is a medication for people struggling with alcohol addiction. Antabuse treatment can have unpleasant effects (called Disulfiram reaction) when Antabuse and alcohol are combined. How does Antabuse work? Read here for the full story.

Alcohol needs to be broken down into smaller parts in order to be excreted (cleared from the body). It needs chemicals (mostly supplied by the liver) to break it down. Here are the basics of how alcohol is metabolized and processed:

1st step to metabolize alcohol:

The first chemical needed in the process is called alcohol dehydrogenase. This is responsible for breaking alcohol into acetaldehyde. Acetaldehyde is a toxic metabolite and is responsible for many of the symptoms caused by a hangover.

High levels of acetaldehyde cause:

  • Nausea,
  • Vomiting,
  • Flushing,
  • Headache,
  • Low blood pressure



Because of the unpleasant effects of high levels of acetaldehyde, it needs to be broken down further in order to feel well.

2nd Step:

The next chemical in the process is aldehyde dehydrogenase which is responsible for breaking down the acetaldehyde further into acetic acid, a harmless substance that can be excreted.

How Antabuse works: Why disulfiram Antabuse makes you feel sick if you drink alcohol

Disulfiram Antabuse is a medication for people struggling with alcohol addiction. Antabuse treatment can have unpleasant effects (called Disulfiram reaction) when Antabuse and alcohol are combined. How does Antabuse work? Read here for the full story.

How does Antabuse work? Disulfiram blocks Step 2: the ability for aldehyde dehydrogenase to break down the acetaldehyde. This means acetaldehyde stays around in the system creating the unpleasant effects that happen with high acetaldehyde levels (listed above).

 

The physical effects that happen from the toxic acetaldehyde start within about 10 minutes of drinking alcohol and last for an unpleasant 1+ hours depending on the amount of alcohol consumed.

Antabuse and alcohol: What could happen during a Disulfiram reaction?

Disulfiram Antabuse is a medication for people struggling with alcohol addiction. Antabuse treatment can have unpleasant effects (called Disulfiram reaction) when Antabuse and alcohol are combined. How does Antabuse work? Read here for the full story.

Here is a good summary of what can happen when disulfiram and alcohol are combined. This is called a disulfiram reaction:

 

Disulfiram plus alcohol, even small amounts, produce flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death.

 

The intensity of the reaction varies with each individual, but is generally proportional to the amounts of disulfiram and alcohol ingested. Mild reactions may occur in the sensitive individual when the blood alcohol concentration is increased to as little as 5 to 10 mg per 100 mL. Symptoms are fully developed at 50 mg per 100 mL, and unconsciousness usually results when the blood alcohol level reaches 125 to 150 mg.



How long does Disulfiram Antabuse stay in the body?

Disulfiram Antabuse is a medication for people struggling with alcohol addiction. Antabuse treatment can have unpleasant effects (called Disulfiram reaction) when Antabuse and alcohol are combined. How does Antabuse work? Read here for the full story.

Antabuse is quite long-acting (slow to be cleared from the body) and a reaction may occur up to 2 weeks from the last dose of the medication!

 

Until it is fully cleared a person will get sick if they drink alcohol and I highly recommend not experimenting to see if you can drink sooner. I have heard stories of patients who are able to drink after 4 days but I have also heard stories of patients who have tried this and have been sicker from the disulfiram reaction than they ever were in their life.

 

Of course, the amount of time necessary until a person can “safely” drink again does not address the issue of someone struggling with addiction resuming drinking. We all know there are adverse effects that happen with addiction too…

Potential side-effects of Antabuse:

Disulfiram Antabuse is a medication for people struggling with alcohol addiction. Antabuse treatment can have unpleasant effects (called Disulfiram reaction) when Antabuse and alcohol are combined. How does Antabuse work? Read here for the full story.

 

It is important to know this medication cannot be started within 12 hours of consuming an alcoholic beverage. Many of the below-listed side effects are more common in the first 2 weeks of therapy and then disappear. These can also be minimized by lowering the dose if necessary.

 

Side effects include:



  • skin rash,
  • acne,
  • headache,
  • drowsiness or tiredness,
  • impotence,
  • metallic taste or garlic-like taste in the mouth,
  • weakness,
  • loss of appetite,
  • upset stomach and vomiting,
  • yellowness of the skin or eyes,
  • dark urine,
  • rare liver inflammation or failure.

Antabuse treatment: It is an option to aid in recovery from alcohol addictionDisulfiram Antabuse is a medication for people struggling with alcohol addiction. Antabuse treatment can have unpleasant effects (called Disulfiram reaction) when Antabuse and alcohol are combined. How does Antabuse work? Read here for the full story.

Disulfiram Antabuse is not a cure-all for alcohol addiction but it can be a life-saving intervention that, when used along with psycho-social supports, helps support a person that is struggling to achieve abstinence from alcohol.

 

Do you know anyone that has successfully used Disulfiram Antabuse in their recovery? Have you, or anyone you know, experienced the adverse reaction of combining Antabuse and alcohol? What happened?

Please comment with any words of wisdom for people that are wondering if Disulfiram Antabuse treatment is right for them. 

 

To read more about addiction check out these posts:

 

Need help quitting Juul? Learn more about treating Juul addiction.

There is a drug called Lean in school. Have you heard of it?

7 Alternatives to AA in Recovery from Addiction

We Can Help Prevent Prescription Medication Abuse and Drug Diversion

Naloxone: The antidote for opiate overdose

 

 

 

7 Alternatives to AA in Recovery from Addiction

Alcoholics Anonymous (AA) has helped countless people in their recovery from addiction but one size does not fit all with healing. The messages of AA don’t resonate with everyone and it’s important to know alternatives to AA exist. Healing and recovery are lost on some that become distracted by what they interpret as religious aspects of AA. This post is about the other options for a self-help addiction recovery program.

 

The more alternatives to choose from, the greater the chance that people will find a program they identify with. Recovery will still be hard but may be easier to start when it’s the right fit.



Keep in mind, AA is the most prolific addiction recovery program with multiple meetings every day all around the world. It is by far the easiest to attend if you are looking for daily, free, in-person support. However, it is not the only game in town.

 

This post does not cover medication-assisted recovery. This is an important option for many people on their path to recovery and will get covered in a separate post.

SMART Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

SMART Recovery (stands for Self-Managment And Recovery Training) describes itself as a “science-based secular alternative” and is not specific to alcohol, but for any type of addiction (including gambling and other non-substance related dependencies).  It has face-to-face and daily online meetings in addition to a 24/7 chat room and online message board.

 

SMART recovery views addiction as a bad habit and not a disease.

 

The purpose of SMART Recovery according to their website:

 

To support individuals who have chosen to abstain, or are considering abstinence from any type of addictive behaviors (substances or activities), by teaching how to change self-defeating thinking, emotions, and actions; and to work towards long-term satisfactions and quality of life.

SMART Recovery works as a 4-point recovery program based on cognitive-behavioral techniques that teach how to change self-defeating thinking, emotions, and actions. The 4-point program covers building and maintaining motivation, coping with urges, managing thoughts, feelings, and behaviors, and living a balanced life.

 

The SMART Recovery Toolbox provides a variety of methods, worksheets, and exercises to help support you through addiction recovery. Find them here.



Alternative to Alanon:

In addition, Smart Recovery has a friends-and-family section so they can get support and be better prepared to help their loved one.

Refuge Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

Refuge Recovery is a mindfulness-based recovery method founded in Buddhism and focused on compassion. Some of the steps in Refuge Recovery are similar to AA’s like taking an inventory and mentorship.

 

We do not use Buddhism as a religion, but as a liberating approach to a more wholesome life, while remaining thoroughly engaged with the world and cultures in which we live.

 

From their website:

 

Refuge Recovery is a non-profit organization grounded in the belief that Buddhist principles and practices create a strong foundation for the addiction recovery process. Wisdom and compassion enable those struggling with any form of addiction to become more mindful of their mental processes while also developing a deep understanding of the suffering that addiction has created and compassion for their own pain. The mission of Refuge Recovery is to support those on this path of recovery by building an extensive and comprehensive network of Refuge Recovery groups, meetings and communities that practice, educate and provide Buddhist-inspired guidance and meditations for anyone seeking recovery from addiction. We hope to serve you, and meet you on the path.

Refuge recovery has a separate women’s recovery program!

Refuge Recovery has a women’s recovery section called Women’s Recovery and Refuge Online (WRRO) which offers support services for all women (including those that self-identify as women) to ease the suffering caused by addiction.

Women for Sobriety (WFS):Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

An abstinence-based program encouraging spiritual and emotional growth as a way to help women discover a happy new life as they recover from substance use disorders. This program aims to address the emotional needs of women and uses positive reinforcement and thinking, relaxation techniques, meditation, diet, and exercise.

 

WFS has in-person support meetings, a message board, chat room, phone support, and even a yearly conference to go to.

 

WFS believes that having a life-threatening problem with alcohol and/or drug use is not a moral weakness, it is the symptom of a serious disorder which demands rigorous attention to healing. Founded by a sociologist who related over-reliance on substances to the loss of identity many women feel with competing roles in society, WFS believes that guilt, depression, and low (or no) self-esteem are common problems women experience for which substances have become the primary coping mechanism.



Here are the 13 acceptance statements from the Women for Sobriety website:

 

1. I have a life-threatening problem that once had me. I now take charge of my life and my well-being. I accept the responsibility.
2. Negative thoughts destroy only myself.
My first conscious sober act is to reduce negativity in my life.
3. Happiness is a habit I am developing.
Happiness is created, not waited for.
4. Problems bother me only to the degree I permit.
I now better understand my problems. I do not permit problems to overwhelm me.
5. I am what I think.
I am a capable, competent, caring, compassionate woman.
6. Life can be ordinary or it can be great.
Greatness is mine by a conscious effort.
7. Love can change the course of my world.
Caring is all-important.
8. The fundamental object of life is emotional and spiritual growth.
Daily I put my life into a proper order, knowing which are the priorities.
9. The past is gone forever.
No longer am I victimized by the past. I am a new woman.
10. All love given returns.
I am learning to know that I am loved.
11. Enthusiasm is my daily exercise.
I treasure the moments of my New Life.
12. I am a competent woman, and I have much to give life.
This is what I am, and I shall know it always.
13. I am responsible for myself and for my actions.
I am in charge of my mind, my 
thoughts, and my life.

WFS suggests to spend 15 minutes each morning reading and thinking about the acceptance statements and recommends to choose one to “use it consciously all day”.  Close out the day by reviewing and reflecting on your chosen acceptance statement, how you applied it, and how it affected your day.

The Hip Sobriety ProjectRecovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

The Hip Sobriety Project is an 8-week coaching course that includes readings, worksheets, and weekly small-group conference calls. It is an individualized program designed to meet you where you are at in your addiction recovery process. This program is not free but there is a scholarship program for highly-motivated individuals from a disadvantaged background.

 

From the website:

 

Over the course of 8 weeks, you’ll be exposed to a wide-range of tools, teachings, and practices, pulled from all schools of thought and the most recent scientific findings in addiction recovery. The information is delivered in a thoughtful, easy-to-digest manner, and is accessible to you forever.

Through weekly lectures, accompanying workbooks and worksheets, daily emails, daily and weekly exercises, and a vast resource library, this course delivers participants the quintessential field guide on recovery that is not available anywhere else. You’ll walk away empowered with knowledge, and a personalized Hip Sobriety recovery map so that you can put what you learn to work for you and know what step to take, when.

Rational Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

Rational Recovery is an abstinence-based addiction recovery program founded by Jack Trimpey, a recovered alcoholic and social worker. It is based on the Addictive Voice Recognition Technique (AVRT), which teaches recognition of the “addictive voice” that tells you to seek drugs or alcohol.

 

Addiction is not seen as a disease and Rational Recovery rejects the idea of being “powerless” over addictive impulses. With AVRT, a person gains awareness of thoughts and triggers that can cause cravings (named “The Beast”) and through that can override addictive impulses in order to remain abstinent.



There are no meetings. Their website includes instruction on self-recovery from addiction using AVRT instructional videos, downloadable PDF’s, a book, and AVRT teleconferences.

 

The goal in AVRT-based recovery is to live comfortably with residual addictive desire, and not to silence or stave off your Addictive Voice. You should welcome the AV as a sign of health, and not as a threat, because your Beast is utterly powerless to act independently of your will.

Moderation Management:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

This program is not based on abstinence from alcohol but instead on learning how to moderate and control problem drinking behaviors. They use a 9-step program geared toward helping members find balance and moderation with alcohol and also with life.

 

The program provides education, guidelines, exercises, goal-setting, and self-management techniques through their in-person meetings or online support.



Their website explains what Moderation Management is:

 

Moderation Management (MM) is a behavioral change program and national support group network for people concerned about their drinking and who desire to make positive lifestyle changes. MM empowers individuals to accept personal responsibility for choosing and maintaining their own path, whether moderation or abstinence. MM promotes early self-recognition of risky drinking behavior, when moderate drinking is a more easily achievable goal. MM is run by lay members who came to the organization to resolve personal issues and stayed to help others.

Some people find it is more difficult to moderate drinking than it is to abstain completely. MM estimates that 30% of attendees will go on to an abstinence program.

LifeRing Secular Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

LifeRing provides a network (in-person and online) for people who want to be free of addiction. A requirement for membership is a desire to remain abstinent from alcohol and drugs.

 

Per the LifeRing website:

 

In LifeRing, we offer each other peer-to-peer support in ways that encourage personal growth and continued learning through personal empowerment. Our approach is based on developing, refining, and sharing our own personal strategies for continued abstinence and crafting a rewarding life in recovery. In short, we are sober, secular, and self-directed.

The principles of LifeRing are sobriety, secularity, and self-help. LifeRing “supports recovery methods that rely on human efforts rather than on divine intervention.” They believe the key to recovery is the individual’s own motivation and effort.

Books to help with addiction recovery:

There are many great books about addiction and recovery and here are a few. For a full list of my recommended mental health books look here.

More posts about addiction:

Alcohol Use Disorder: Do you have a drinking problem?

Alcohol Dependence and Withdrawal: Are You at Risk?

Naloxone: The antidote for opiate overdose

Will a Prescription Monitoring Program Help Combat Addiction?

 



Find the program that works for you. There are many options for recovery with different philosophies and approaches, in-person meetings, online support, books, etc… AA meetings are practically everywhere but aren’t for everyone. Don’t let that hold up your healing.

 

Please share this list of resources and help spread the word about alternative programs so we can reach the people that may need this.

 

What have you, or a loved one, found to be helpful for addiction recovery? What programs, books, or resources am I missing? Let me know so I can add them to the list.

 

Naloxone: The antidote for opiate overdose

We can do more to stop the surge of deaths from opiate overdose. Naloxone is an opiate overdose treatment. It is an antidote that can be used to reverse an opiate overdose (like a heroin overdose). Did you know that over 33,000 people in the United States died from opiate overdoses in 2015? In Connecticut alone there were 723 opiate overdoses in 2015, 444 of them were fatal. According to the CDC, drug overdoses are the leading cause of death of Americans under 50 years old.

 

Ambulances and hospitals have been treating overdoses with Naloxone for decades.  Given the current opiate epidemic, steps have been taken to make Naloxone more accessible to the general public. Naloxone can save the life of a person who is overdosing on an opiate.


Opiate Overdose TreatmentHow do I know someone is having an opiate overdose?

If a person with a known history of opiate use is showing any combination of the following symptoms seek immediate medical attention by calling 911. The chances of surviving an overdose are significantly increased if Naloxone is immediately provided.

Opiate overdose symptoms:

  • Unconscious or minimally responsive with excessive drowsiness or inability to wake the person from sleep. They don’t respond when you shake or pinch them or rub your knuckles hard on their breastbone.
  • Slowed or no breathing at all- they might be making loud snoring or gurgling sounds
  • Pinpoint or very small pupils
  • Slowed heartbeat
  • Blue or grey color especially around the fingernails or lips
  • Pale and clammy skin

What should you do if someone overdoses?

1. Call 911

If you are unable to arouse the person call 911 – tell them the person isn’t breathing or is having trouble breathing. In Connecticut, you are protected from arrest for drug possession if you act as a Good Samaritan by seeking medical assistance for a person you believe is overdosing. Good Samaritan laws vary by state. Click here to see what the laws are in your state.

 

Even if you have naloxone with you it is still essential to call 911. Different opiates have various strengths and length of time they last. If a person overdoses on a powerful drug like fentanyl they may end up requiring multiple repeat doses of Naloxone to survive the overdose. It is essential that emergency personnel be immediately notified so they can provide continued care and life-saving treatment.

2. Rescue breathing

If the person isn’t breathing give them rescue breaths. You can help the person get oxygen.

 

  • Put them on their back and open their airway by tilting their head back and lifting their chin.
  • Pinch their nose and give 2 breaths first, then one breath every 5 seconds.
  • Continue to breathe for the person until they respond to the Naloxone or emergency personnel arrive.

Click on this link for more images and instructions about how to do rescue breathing.

3. Give Naloxone for opiate overdose treatment

Once you have given a few rescue breaths give the Naloxone. Give a second dose of Naloxone if there is no response in 2-3 minutes.

 

The Maryland Department of Health has a great summary of how to use the different Naloxone products. The following information on naloxone types and directions is from their website.



There are 4 types of naloxone products available

1. For intranasal administration:

2mg/2mL single-dose Luer-Jet prefilled syringe. Includes one luer-lock mucosal atomization device (MAD 300) per dose dispensed.
Directions for use: Spray 1 mL in each nostril. Repeat after 3 minutes if no or minimal response.

Naloxone
Naloxone for Opiate Overdose
Naloxone
Naloxone for Opiate Overdose
Naloxone
Naloxone for Opiate Overdose

2. For intranasal administration:  Narcan 4mg dose

Directions for use: Place the tip of the nozzle in either nostril until your fingers touch the bottom of the patient’s nose. Press the plunger firmly to release the dose into the patient’s nose. Remove the device from the nostril and discard. Using a new device, repeat after 3 minutes if no or minimal response

Narcan Nasal Spray
Naloxone for Opiate Overdose
Narcan Nasal Spray
Naloxone for Opiate Overdose
Narcan Nasal Spray
Naloxone for Opiate Overdose

 

3. For intramuscular injection:

0.4/mL in 1mL single dose vials. Include one 3cc, 23g, 1″syringe per dose dispensed. Include face shield for rescue breathing and alcohol swabs if available.
Directions for use: Inject 1mL in shoulder or thigh. Repeat after 3 minutes if no or minimal response.

Naloxone
Naloxone for Opiate Overdose
Naloxone
Naloxone for Opiate Overdose

 

4. For intramuscular or subcutaneous injection:

EVZIO® 0.4mg/0.4mL auto-injector, #1 Two-Pack.
Directions for use: Follow audio instructions from the device. Place on the thigh and inject 0.4 mL. Repeat after 3 minutes if no or minimal response.

Naloxone
Naloxone for Opiate Overdose
Naloxone
Naloxone for Opiate Overdose
Naloxone
Naloxone for Opiate Overdose

How does Naloxone work?

Naloxone neutralizes the opioids in the body reversing the symptoms of an opiate overdose. It will help the person regain consciousness and breath again.  Naloxone is an antidote to powerful drugs like heroin, methadone, fentanyl, and morphine. Naloxone only works with opiates and will not reverse an overdose from any other substance.

What are the side effects of Naloxone?

Most of the time Naloxone will cause opiate withdrawal symptoms which may be uncomfortable, but they are not life-threatening. These may include headache, changes in blood pressure, rapid heart rate, sweating, nausea, vomiting, diarrhea, stomach pain, and tremors.

Where can I get Naloxone?

Availability of Naloxone to non-medical personnel depends on the state you live in. In some states, you need a physician’s prescription to get Naloxone while in others pharmacists can prescribe it. Visit this link to read more about the laws regarding naloxone in your state. To see your state’s information, click on the map and then click on your state. You will then be able to see what the laws are for obtaining a prescription and the laws regarding immunity from prosecution and liability.

 

Many states have created maps of pharmacies that can dispense Naloxone. To see if your state has a compiled this data google “naloxone pharmacies in….name of state….”. Once you find this website you will know exactly which pharmacy you can go to get Naloxone.

How much will Naloxone cost?

Many insurance companies will pay for Naloxone. If the Naloxone is not covered look for manufacturer coupons online or go to GoodRx which will give prices and coupons for Naloxone at various local pharmacies.

 

Each form of Naloxone will cost a different amount. On GoodRx Narcan, which provides two doses of the 4mg intranasal naloxone, is $135. Two vials (one vial per dose) of naloxone to inject are $20 vs 2 doses of Evzio auto-injector are $3,800!! However, Evzio has several patient assistance programs and coupons. If the medicine is ordered through their site without using insurance it is $360. With insurance, they have coupons that will make the copay zero.

Should I get Naloxone?

If you have a loved one that requires prescription opiates or is struggling with opiate addiction I urge you to strongly consider getting Naloxone to carry with you. Unfortunately, the opiate epidemic isn’t disappearing anytime soon and too many people are dying from overdoses.

 

Naloxone is a safe and effective tool that can save lives. Think of carrying Naloxone like carrying an EpiPen for someone with allergies. Hopefully, you will never need it but it has the potential to save their life in an emergency. Talk to your doctor or pharmacist to find out if obtaining Naloxone is right for you.

 

For more information about addiction I recommend the following books:

 

 

Alcohol Dependence and Withdrawal: Are You at Risk?

Are you at risk for alcohol withdrawal?

First and foremost if you think you need help to stop drinking alcohol let your doctor know! Withdrawal can be deadly and you want to make sure to detox correctly. Your physician can help you determine your risks and recommend whether inpatient or outpatient treatment is necessary. An individualized treatment plan combined with the right support can increase your chance to successfully and safely stop drinking. The information in this post is not to be used in place of your doctor’s opinion and advice so go get yourself help!


alcohol withdrawalDo you qualify for a diagnosis of Alcohol Use Disorder?

Check out my post on criteria for alcohol use disorder to see if you qualify. If you do, this 20 question survey can help define if you are dependent on alcohol and at risk of experiencing withdrawal: http://www.drinksafely.soton.ac.uk/SADQ/SADQQuiz/?.

Alcohol dependence and withdrawal

Alcohol withdrawal can happen when a person who is alcohol dependent stops drinking or drinks significantly less.  It usually starts within hours of the alcohol level markedly decreasing. Withdrawal varies in duration and severity and can clear within hours or take up to 2 weeks. The more episodes of withdrawal a person has the more severe future withdrawals will be. Many patients who develop alcohol-related seizures have an increased number of previous detoxes.


alcohol withdrawal timelineInfographic courtesy of the American Addiction Center

Alcohol withdrawal symptoms

Possibly withdrawal symptoms: increased blood pressure and pulse, tremor, sweating, elevated temperature, nausea, vomiting, anxiety, agitation, insomnia, irritability, impaired memory and judgement, hallucinations, delirium, seizures.  Alcohol withdrawal is nearly always associated with a depressed mood.



Delirium Tremens (DT’s)

Delirium Tremens (DT’s) is a severe and potentially life-threatening condition that usually starts 48-72 hours after the last drink. It happens in 3-5% of people with withdrawal.  People are usually hyper-alert, hyperactive, agitated, disorientated, have a tremor, fever, changes in blood pressure and pulse, perceptual distortions, and hallucinations. Visual hallucinations happen more in DT’s but hallucinations, in general, can happen both in withdrawal or DT’s. DT’s require intensive medication management to treat. Even with treatment, the mortality rate is 5-10%. 80% of cases resolve within 72 hours.

Treatment of Alcohol Withdrawal

Treatment is available to help with alcohol withdrawal and will increase the chance of getting off alcohol safely. Benzodiazepines (such as Ativan, Serax, Librium, and Valium) are the main medicines used to treat withdrawal and should be started at the onset of symptoms. They reduce the severity of withdrawal and decrease the incidence of seizures and Delirium Tremens. People withdrawing from alcohol are sometimes prescribed benzodiazepines as an outpatient or they are used for inpatient detox. Inpatient alcohol detoxification is necessary for people with fever, seizures, inability to eat or drink, medical illness, agitation, hallucinations, poor judgement, history of severe withdrawal, poor social supports, and poor compliance.

 

Again- this is worth repeating- let your doctor know if you think you need help to stop drinking. Get an individualized treatment plan and the right support so that you can successfully and safely stop drinking.

 

I recommend these following books to read more about addiction:

 

 

Alcohol Use Disorder: Do you have a drinking problem?

Do I have a drinking problem? It is not uncommon for people who drink alcohol to wonder if their drinking is normal or problematic (or somewhere in between). Some people have alcohol addiction that runs in their families so they know they are at risk for addiction. They want to monitor their drinking closely to make sure they don’t have a drinking problem. Others are confronted by loved ones who think they may have alcohol abuse and the person isn’t sure they agree. Do you want to see if you meet criteria for the diagnosis of Alcohol Use Disorder? Read here to find out.

Do I have a drinking problem?Do I have a drinking problem? Am I at risk for alcohol addiction? Read here to see if you qualify for a diagnosis of alcohol use disorder. See the new criteria for the diagnosis and learn more about if alcohol abuse is an issue for you or your loved one.

Do I have a drinking problem? Am I at risk for alcohol addiction? Read here to see if you qualify for a diagnosis of alcohol use disorder. See the new criteria for the diagnosis and learn more about if alcohol abuse is an issue for you or your loved one.

Here are the newest diagnostic criteria from the DSM-5 (the diagnostic manual put out by the American Psychiatric Association).

 

Take this survey and see how you score:

In the past year, have you:

    1. Had times when you ended up drinking more, or longer, then you intended?
    2. More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
    3. Spent a lot of time drinking? Or being sick or getting over other aftereffects?
    4. Wanted a drink so badly you couldn’t think of anything else?
    5. Found that drinking- or being sick from drinking- often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
    6. Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
    7. Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
    8. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart?



Do I qualify for Alcohol Use Disorder?

 

drinking problem

The presence of at least 2 of these symptoms indicates an Alcohol Use Disorder.

 

Alcohol Use Disorder is divided into mild, moderate, and severe.

Mild: The presence of 2 to 3 symptoms

Moderate: The presence of 4 to 5 symptoms

Severe: The presence of 6 or more symptoms



Alcohol Abuse and Withdrawal vs. Alcohol Use Disorder

Alcohol Use Disorder previously was called alcohol abuse and alcohol dependence. Here is an article from the NIH discussing the change in diagnostic terms: http://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf.

 

If you have Alcohol Use Disorder:

If you qualify for Alcohol Use Disorder it is important for your provider to be aware even if you aren’t ready to stop drinking. Alcohol Use Disorder can complicate clinical assessments and treatment if the provider isn’t informed. If you would like to stop drinking you may need professional assistance to do it safely.

 

If you have Alcohol Use Disorder assess your risk for withdrawal symptoms if you stop drinking. See my post on alcohol dependence to read more about this risk.

 

I recommend these books to read more about alcohol addiction: