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Alcohol withdrawal syndrome is a cluster of symptoms that occurs in alcohol-dependent people after cessation or reduction in alcohol use. Some people have mild shakiness and sweats. The worst form of withdrawal is called “DTs. Alcohol withdrawal refers to a group of symptoms that may occur from suddenly stopping the use of alcohol after chronic or prolonged ingestion. Alcohol withdrawal usually occurs in adults, but it may happen in teenagers or children as well. It can occur when a person who uses alcohol excessively suddenly stops drinking alcohol. The withdrawal usually occurs within 5 - 10 hours after the last drink, but it may occur up to 7 - 10 days later. Alcohol enhances the effect of GABA on GABA-A neuroreceptors, resulting in decreased overall brain excitability. Hallucinations occur in 3%–10%  of patients and are usually visual; their onset and duration  are variable but typically begin after several days of  abstinence.  Convulsions, which are usually 1 or 2 grand  mal seizures, occur in 5%–15% of patients during acute  alcohol withdrawal and typically occur within 6 to 48  hours after alcohol cessation.

Alcohol inhibits NMDA neuroreceptors, and chronic alcohol exposure results in up-regulation of these receptors. Alcohol withdrawal differs significantly from withdrawal from other drugs in that it can be directly fatal. While it is possible for heroin addicts, for instance, to die from other health problems made worse by the strain of withdrawal, an otherwise healthy alcoholic can die from the direct effects of withdrawal if it is not properly managed.  Acute alcohol withdrawal can produce some of the  more serious morbidity related to alcohol consumption. Clinical features of alcohol withdrawal follow the cessation  of regular high-dose alcohol ingestion as soon as  the blood alcohol level decreases significantly.21Within 6  to 24 hours after stopping drinking, tremors, nausea and  vomiting, anxiety, mild agitation, tachycardia, hypertension,  insomnia and diaphoresis may occur. The risk of seizures increases with the duration of alcohol abuse. The alcoholic could suffer from loss of respect from others who may see the problem as self-inflicted and easily avoided.

Alcohol  consumption is more strongly associated with seizures  than is alcohol withdrawal. Treatment may require maintenance of a moderately sedated state for a week or more until withdrawal is complete. Medication can be administered using fixed-schedule or symptom-triggered regimens. Multivitamins and thiamine (100 mg per day) should be provided during treatment for alcohol withdrawal. Rehabilitation for alcoholism is often recommended. This may include social support such as Alcoholics Anonymous, medications, and behavior therapy. Pharmacologic treatment of alcohol withdrawal syndrome involves the use of medications that are cross-tolerant with alcohol. Benzodiazepines have been shown to be safe and effective, particularly for preventing or treating seizures and delirium. Detoxification treats the physical effects of prolonged use of alcohol, but does not actually treat alcoholism. Haloperidol (Haldol) can be used to treat agitation and hallucinations, although it can lower the seizure threshold.

Alcohol Withdrawal Treatment Tips

1.Detoxification treats the physical effects of prolonged use of alcohol, but does not actually treat alcoholism.

2.Group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction.

3.Rationing and moderation programs such as Moderation Management do not mandate complete abstinence.

4.Sodium oxybate is the sodium salt of gamma-hydroxybutyric acid (GHB).

5..Pharmacologic treatment of alcohol withdrawal syndrome involves the use of medications that are cross-tolerant with alcohol.

6. Benzodiazepines have been shown to be safe and effective, particularly for preventing or treating seizures and delirium.

7.Adjunctive treatment with a beta blocker should be considered in patients with coronary artery disease.

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