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Alcohol withdrawal - Treatment

Treatment:

The goals are to treat the immediate withdrawal symptoms, prevent complications, and begin long-term therapy to promote abstinence (no drinking at all).

The person will probably have to stay at the hospital for constant observation. This will include monitoring:

  • Blood pressure
  • Body temperature
  • Breathing
  • Heart rate
  • Fluid and electrolyte levels (chemicals in the body such as sodium and potassium)

Many patients are given fluids or medications through a vein (IV).

Withdrawal symptoms may worsen rapidly and may quickly become life threatening. Drugs that depress the central nervous system (such as sedatives) may be needed to reduce symptoms, often in moderately large doses.

Treatment may involve placing the person in a a moderately sedated state for 1 week or more until withdrawal is complete. A class of medications known as the benzodiazepines are often useful in reducing a range of symptoms.

The health care provider will watch closely for signs of delirium tremens.

Hallucinations that occur without other symptoms or complications are uncommon. They are treated with hospitalization and antipsychotic medications as needed.

Testing and treatment for other medical problems associated with use of alcohol is necessary. Disorders related to the use of alcohol include:

A drying-out period is recommended after withdrawal is complete. No alcohol is allowed during this time. Permanent and lifelong abstinence from alcohol is the best treatment for those who have gone through withdrawal.

Rehabilitation for alcoholism is often recommended. This may include social support such as Alcoholics Anonymous, medications, and behavior therapy.

Support Groups:

For additional resources, see alcoholism support group.

Expectations (prognosis):

Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition. Symptoms usually begin within 8-12 hours of the last drink. The symptoms peak in 48 - 72 hours and may persist for a week or more.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for 3 - 12 months or more. If a person continues to drink excessively, they may develop many medical conditions such as liver and heart disease.

Most people who go through alcohol withdrawal make a full recovery. The long term outlook depends on how much organ damage has occurred and whether the person can stop drinking completely.

Calling your health care provider:

Alcohol withdrawal is a serious condition that may rapidly become life threatening.

Call your health care provider or go the emergency room if symptoms suggest alcohol withdrawal, especially in a person who has a history of habitual use of alcohol, or a history of stopping use of alcohol after a period of heavy alcohol consumption. Call for an appointment with your health care provider if symptoms persist after treatment.

Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, delirium or severe confusion, hallucinations, or irregular heart beats occur.

  • Reviewed last on: 2/27/2009
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

O’Connor PG. Alcohol abuse and dependence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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