Consumption of alcoholic beverages is considered a customary social practice in many countries including our own, with 66% percent of Americans admitting to occasional alcohol use. Yet, trying to decipher why so many of those occasional drinkers become alcohol dependent is a more complicated equation. Currently, a mind-boggling 1 in 12 adults in the U.S. suffer from alcohol addiction, a number that does not come as a surprise considering that alcohol is the most commonly used addictive drug. To make matters worse, patients who attempt to quit alcohol use fail in the majority of cases due to the unbearable and life-threatening withdrawal effects. Alcohol is no different than any other addictive drug (legal or illegal) and, as a result, everyone is subject to its dependent properties and withdrawal symptoms. Therefore, for those who want to end the addictive cycle, the first – and most important – step is to recognize that they have become dependent and subsequently to acknowledge the need for professional medical assistance.
Alcohol is a substance that affects the GABA (gamma-aminobutyric acid) receptors in the brain, which are known for their inhibitory effects in the central nervous system. The typical GABA effects include: sedation, amnesia, hypnosis, relaxation, and euphoria. Patients who drink alcohol regularly will manifest the aforementioned effects but when they abruptly quit, the central nervous system goes into a hyperactive mode in which there is a reversal of the normal GABA effects. The alcohol withdrawal symptoms can be noted as early as 6 hours from alcohol cessation. The classic minor withdrawal signs include: insomnia, shivers, anxiety, anorexia, headache, profuse sweating, and palpitations. Alternatively, in moderate to severe withdrawal, patients develop seizures and delirium tremens, a condition whereby patients develop hallucinations, disorientation, fever, and agitation. Patients with delirium tremens, the most extreme form of withdrawal, manifest symptoms within 48 to 96 hours from the last drink and can continue in this state for about one week. The treatment for withdrawal symptoms includes medications in the benzodiazepine class (e.g. lorazepam), which are drugs that exert their activity on the GABA receptor. These medications ameliorate the symptoms and return the body to a balanced state. Patients will also need replenishment of their electrolytes and significant hydration.
Studies have shown that even just one week of excessive drinking can lead to withdrawal, which could culminate in alcohol dependency. Furthermore, if patients enter into an extreme withdrawal state, their risk of death significantly increases. A variety of risk factors for alcohol abuse have been delineated; patients who should be extra cautious are those with a family history of alcohol abuse and those with psychiatric disorders because they tend to have a predisposition for dependency. Once a patient recognizes that they have alcohol dependency, they must seek medical treatment through their primary care physician or the emergency room. Not everyone needs to be in a hospital setting, and outpatient therapy is a valid and effective option with a 90% success rate. Getting professional help is the only realistic way to keep patients healthy and sober because without medical treatment, most patients end up grabbing another bottle of booze just to remain physically collected.