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By Boris M | 25 July, 2020 Published in Alcohol Withdrawal Symptoms
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When regular alcohol consumption becomes a way of life, it can be extremely difficult to let the habit go and change course for a bright and healthy tomorrow. Cessation of alcohol can lead to alcohol health complications. In this post, we will discuss how medications, like benzodiazepines, can be used to treat alcohol withdrawal.

The brain adjusts itself after prolonged alcohol abuse so that more alcohol is required to achieve the same effect. Once the brain and body begin demanding more and more alcohol, a physiological dependence can form that may make it very difficult or painful to discontinue use.

This condition is known as “withdrawal”, and it can have an enormous impact on the wellbeing and quality of life of the people who are affected. It can also be fatal if left untreated, or without the proper assistance of a medically-supported detox.

Alcohol Withdrawal Syndrome

Continual use of alcohol creates what is known as “alcohol withdrawal syndrome,” as the body becomes dependent on a synthetic substance. Withdrawal can vary in severity from minor to extremely pronounced. More severe symptoms include hallucinations, seizures, nausea, anxiety, and more.

If left untreated, these symptoms can increase in intensity, or even lead to rare cases of death once the delirium tremens stage has been reached.

While symptoms are commonly less severe within the first 24-hour period after having a final drink after this time period is when the risk of more serious symptoms and effects begins to take place.

While seizures due to alcohol withdrawal are fairly rare, more than 90% occur within the first 48 hours after the person stops drinking. [1] Although alcoholism is a widespread and pervasive condition that affects almost every segment of our society, understanding the role of medication and how it can be beneficial in confronting the symptoms of withdrawal is a great way to be prepared to face this challenge.

Why and How is Medication Used?

Of all the treatments that exist to deal with the symptoms of withdrawal, benzodiazepines sit atop the list as the most frequently used medical option with the most extensive amount of research to support it.

Many more are available, however, and proper care, as well as essential vitamins, are a key part of any recovery strategy. Barbiturates, anticonvulsants, GABA agonists, and adrenergic drugs have also all shown the potential to counteract the unwanted symptoms of alcohol withdrawal in various ways and measures. [2]

benzodiazepines

What are Benzodiazepines?

Benzodiazepines work to depress the nerves in the brain and typically lead to a sensation of drowsiness or tiredness. This process impacts the nerve impulses throughout the brain, which are highly associated with alcoholism and withdrawal syndrome.

Benzodiazepines treat symptoms that range from headaches and nausea to stress and irritability. Alcohol dependence results in erratic behaviour and symptoms with a rapid onset, which benzodiazepines can help mitigate. [3]

How are Benzodiazepines Used for Alcohol Withdrawal?

Benzodiazepines are administered during the detoxification phase of alcohol withdrawal. This is when it is common to be confronted with the conditions of withdrawal syndrome.

This ranges from a few days to a few weeks, pending on individual circumstances. Allowing the body to relax and slow down gives it the best possible opportunity for success upon entering recovery.

Some of the most common types of benzodiazepines are Diazepam, Chlordiazepoxide, Oxazepam, and Lorazepam. With that, let’s examine each in more detail and how they affect alcohol withdrawal syndrome. [4]

The Four Main Types of Benzodiazepines

Below we have discussed the four main types of benzodiazepines to you to help alleviate alcohol withdrawal symptoms. These include:

Available in both tablet and injection, Diazepam (Valium) is among the most common of benzodiazepines, and has long-lasting effects that are ideally suited for treating recurring symptoms often associated with alcohol withdrawal.

These effects and timespan make it a good choice for dealing with muscle spasms, seizures, insomnia, anxiety, and more.

Chlordiazepoxide (Librium) reduces withdrawal symptoms to make the recovery process more manageable, and can be a great option for treating anxiety.

Several uses exist for this drug during recovery, and can be prescribed by the proper healthcare professional throughout the treatment process.

Oxazepam (Serax) is a drug that allows the body to relax and quell racing thoughts, stress, and other factors often associated with the process of alcohol withdrawal syndrome. 

It is to be taken three to four times a day, and should strictly not be taken twice in the instance of a missed dose. If you exhibit symptoms such as light-headedness, confusion, or hallucinations, call your doctor immediately.

Lorazepam (Ativan) is a capable drug known to treat seizures and epilepsy, while also proving to be an option for alleviating anxiety. This particular type can work within 20 to 30 minutes of consumption, and can last up to eight hours in their sedative effects.

Sleepiness is a common side-effect of Lorazepam, and it should not be taken before operating heavy machinery or be taken for longer than four weeks.

Benzodiazepines prescriptions are often accompanied by the administering of vitamins either in tablet form or through IV therapy.

IV therapy hydrates the patient while transitioning them from mild or severe alcohol withdrawal syndrome toward their first steps to a safe and healthy recovery.

What Are the Different Regimes for Administering Benzodiazepines?

A variety of dosages and ways of administering benzodiazepines exist. Each has its own advantages and benefits for specific conditions, symptoms, and levels of withdrawal syndrome.

Usually, a qualified medical professional will help to determine the right approach for delivering an appropriate dosage pattern. This deals with the effects and levels of withdrawal syndrome that the patient is experiencing.

Many options and strategies exist, but some of the most common include: [5]

  • Fixed tapering dose regimen (FTDR) is when patients are given a fixed dose of their benzodiazepine medication. It is most commonly administered to patients with more mild and manageable withdrawal symptoms
  • Symptom triggered regimen (STR) is for inpatient treatment situations where patients can be closely monitored by a healthcare professional. This approach allows patients to rate the level of pain they are experiencing and have dosage levels adjusted accordingly
  • Loading dose regimen (LDR) is for more severe cases of withdrawal that require longer-lasting doses to target specific symptoms. It is used under professional supervision within the setting of an inpatient clinic

However, as with most forms of medicine, benzodiazepines don’t come without their own share of side-effects and risks. If improperly used or taken outside of the prescribed regimen, benzodiazepines can cause heart problems and other health risks, along with being habit-forming and potentially addictive. [6]

Is it Possible to Become Dependent or Addicted to Benzodiazepines?

Dependence and addiction are two separate conditions. Patients who demand benzodiazepines to feel ‘normal enough to function’ are addicted to the drug. this is a clear indication that dependence has been created from the benzodiazepines.

This can lead to many additional symptoms that could include sweating, tremors, panic attacks, and more. While seeking remedies and solutions to deal with the incapacitating condition of alcoholism is a noble endeavour, dangers can present themselves when alcohol and benzodiazepines are combined.

Benzodiazepines and alcohol can have devastating consequences. These include addiction, increased health risks, or enhanced effects that can cause hallucinations or delirium tremens.

The Risk of Mixing Alcohol and Benzodiazepines

Alcohol is the most frequent substance that benzodiazepine users abuse. Many benzodiazepine users are already dealing with a substance abuse problem. But it becomes extremely important that they resist any urges to combine their regular benzodiazepine doses with alcohol. Using both alcohol and benzodiazepine at the same time carries with it an increased risk of overdose.

Overdosing can leave disastrous results that may include organ failure or even death in extreme situations. This emphasizes the need to use benzodiazepine medications only as prescribed. It also increases the need to get help immediately if any situation arises where alcohol and benzodiazepine could be mixed.

The body processes alcohol before processing any drug, whether illicit or prescription. This means drugs stay in the body longer than normal. Benzodiazepines are an important part of recovery when prescribed by a licensed professional.

Finding The Right Approach

Finding the right approach varies for each individual. By taking benzodiazepines safely, those suffering from alcohol withdrawal can discover new hope and opportunity in their struggle against their symptoms.

No matter where you are in the recovery process, options exist to confront the many challenges that they face. It may seem hard to know where to turn. But by finding the right program or facility with caring professionals, there’s no limit to the progress that can be made.

Ready to start your recovery?

If you’re thinking about getting help for your alcohol addiction, you’ve come to the right place.

Calling us today on 0800 140 4690 is the first step in the right direction.

References

[1] https://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf

[2] https://bnf.nice.org.uk/treatment-summary/alcohol-dependence.html

[3] https://www.mind.org.uk/information-support/drugs-and-treatments/sleeping-pills-and-minor-tranquillisers/about-benzodiazepines/

[4] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005063.pub3/full

[5] https://www.aoaam.org/resources/Documents/2018%20Convention%20Slides/Saturday%20-%2010-6-2018%20-%2011am%20-%20Management%20of%20Withdrawal%20-%20Alcohol%20Benzodiazepines%20Opioids%20-%20Kmiec.pdf

[6] https://emcrit.org/wp-content/uploads/2009/09/Diazepam-in-the-Treatment-of-Moderate-to-Severe-Alcohol-Withdrawal.pdf

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