Alcohol abuse is a serious problem that can have a devastating impact on individuals and their families. Substance abuse treatment is an important step in the recovery process, and family interventions can be a first step to recovery. Heavy drinkers who suddenly decrease their alcohol consumption or who abstain altogether may experience alcohol withdrawal (AW) symptoms, such as mild to moderate tremors, irritability, anxiety, or agitation. The most severe manifestations of withdrawal include delirium tremens, hallucinations, and seizures.
These symptoms are caused by alcohol-induced imbalances in brain chemistry that cause excessive neuronal activity if alcohol is retained. Management of AW includes a thorough assessment of the severity of the patient's symptoms and any complicating conditions, as well as treatment of withdrawal symptoms with pharmacological and non-pharmacological approaches. Treatment can be performed both inpatient and outpatient. Recognition and treatment of abstinence may represent a first step in the patient's recovery process.
Most doctors, alcohol detox centers, and rehabilitation centers turn to the family of drugs known as benzodiazepines, as they can help the person's body calm down. Epileptic status is rare in isolated alcohol abstinence, although alcohol withdrawal often complicates seizure disorders from other causes. Alcoholic patients are at risk of relapse for numerous reasons, including improper treatment of their withdrawal symptoms, constant expectation of the rewarding effects of alcohol and feelings of distress due to the absence of alcohol. With chronic exposure to alcohol, GABA receptors respond less to the neurotransmitter and higher alcohol concentrations are required to achieve the same level of suppression.
In contrast, in some alcoholics, withdrawal symptoms may occur at blood alcohol concentrations (BAC) that would be intoxicating in non-alcohol-dependent people, but which for dependent patients represent a decrease compared to their usual BAC. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A) is a series of questions used to measure alcohol withdrawal. The finding correlates with previous findings that state exposure to alcohol during brain development increases the risk of hallucinations during detoxification. Excessive excitability of the nervous system during periods of alcohol withdrawal is related to the effect of alcohol on the number and function of brain receptors.
Those who drank for a long time or drank a lot of alcohol on a regular basis seem to have the most severe symptoms of alcohol withdrawal. Serious health risks, such as hallucinations, seizures, psychosis, and delirium tremens, are possible for people with a long history of regular heavy drinking, but these complications are difficult to predict. Alcohol detoxification is the very beginning of addiction treatment, but it is important to note that several symptoms can appear in several stages. Because of their similar effects, benzodiazepines and alcohol are cross-tolerant; in other words, a person who is tolerant to alcohol is also tolerant to benzodiazepines.
Ethanol hallucinosis occurs in people who are not withdrawing from alcohol, but who consume alcohol chronically on a constant basis. Alcoholic hallucinosis is a situation that begins approximately 24 hours after the last alcoholic beverage, persists for a few days and causes distress to the individual. Certain risk factors may alert the residential detoxification team to possible complications, such as hallucinations or seizures, that arise as detoxification progresses.
