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Alcohol Withdrawal

Alcohol withdrawal is a set of symptoms that occur when someone stops or significantly reduces the consumption of alcoholic beverages. The alcohol withdrawal syndrome typically involves a range of physical and psychological effects, as the body responds in a hyper-excitable way to a lack of alcohol in the system. Alcohol withdrawal is often managed through detox, with rehab clinics helping people to stop drinking through a combination of medication treatment, therapy and relapse prevention programs.

Alcohol withdrawal is one of the major signs of alcohol dependence, along with increased tolerance and uncontrolled drinking patterns. Signs and symptoms of withdrawal occur mostly in the central nervous system, with typical symptoms starting 6-24 hours after the last drink. While alcohol rehab centers deal with people at all stages of addiction, the alcohol withdrawal syndrome is only formally recognized if two of the following symptoms are observed: insomnia, increased hand tremor, vomiting or nausea, psychomotor agitation, anxiety, transient hallucinations, tonic-clonic seizures, and autonomic instability. Hallucinations can be auditory, tactile or visual, with the severity of symptoms highly dependent on the extent and length of addiction.

Alcohol Withdrawal Progression

The alcohol withdrawal syndrome progresses through a number of distinct phases, with the first symptoms beginning as little as 6 hours after the last drink. Early symptoms are likely to include headaches, sweating, anxiety, nausea, and vomiting, with more severe symptoms starting from 12-24 hours after the cessation of alcohol. During this period, patients are likely to experience mental confusion, hallucinations, tremor, and agitation. The final acute phase of alcohol withdrawal occurs from 24-48 hours after cessation, with early symptoms still experienced and seizures also possible for long-term addicts. Seizures can be very dangerous and even fatal for the alcoholic, with ongoing medical supervision and medication required during this phase.


A range of medications are used to manage the withdrawal syndrome, with benzodiazepines commonly taken to suppress withdrawal symptoms and reduce the chance of seizures. While both long-acting and short-acting benzodiazepines can be used to treat and prevent withdrawal, chlordiazepoxide and diazepam are often preferred for their long half-life. The use of these drugs has proved to be effective over many years, with benzodiazepines the most commonly prescribed medication for alcohol withdrawal. The administration of these drugs requires a lot of care, however, with cross tolerance between alcohol and benzodiazepines possibly causing overdose. The continued use of benzodiazepines can also lead to addiction, with doctors and medical staff needing to evaluate each case individually when deciding on a treatment program.

Other Medications

In addition to benzodiazepines, a number of other medications can also be used to treat alcohol withdrawal. There is some evidence that topiramate, carbamazepine and other anticonvulsants are effective in treatment, with antipsychotics such as haloperidol also used to control agitation and psychosis. Vitamins also play a big role in managing withdrawal, with the intravenous administration of thiamine, folate and pyridoxine often useful during the recovery process. Vitamins should always be given to patients before carbohydrates or glucose, with patients evaluated and tested individually before treatment.

Behavioral Therapy

According to the National Institute on Drug Abuse (NIDA), detoxification should always be followed by drug treatment when required and ongoing behavioral therapy. While therapy is not a part of the detox process itself, it is an essential element in reducing relapse rates among recovering alcoholics. A number of therapies and counseling programs are useful in the context of alcohol recovery, including family therapy, motivational interviewing, motivational incentives, 12-step programs, and group support. Behavioral therapy teaches patients how to deal with their emotions and thoughts, providing them with the skills and support they need to break the bonds of addiction and start a new healthy life.

To find out more about how we can help you or a loved one manage and treat alcohol dependence, call Alcohol Treatment Centers Bronx at 212-202-5656.

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