Benzodiazepines for Alcohol Withdrawal
One of the hardest parts of getting sober for many individuals is going through alcohol withdrawal, which can be incredibly painful and in some cases fatal. To help patients get through initial detox, additional medication is may be necessary. Some of the most commonly prescribed and effective medications for this purpose are various Benzodiazepines.
Benzodiazepines for Alcoholism Withdrawal
Benzodiazepines (or “Benzos”) are a class of man-made medications. There are a large number of drugs classified as Benzodiazepines, each of which is different. In general, however, Benzodiazepines depress the central nervous system (the nerves in the brain) to some degree and cause drowsiness and sleepiness.
Although the exact mechanism by which each Benzodiazepine works is not fully understood, it involves enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. This slows down nerve impulses throughout the entire body and drastically reduces the brain’s output of other neurotransmitters such as Norepinephrine, Serotonin, acetyl choline and dopamine. These neurotransmitters are necessary for alertness, memory, muscle tone and coordination, emotional responses, endocrine gland secretions, heart rate, and blood pressure. The use of benzos impairs all of these functions which results in a relaxed state.
Alcohol use impacts the way the brain functions. This rewiring becomes increasingly severe the longer and more severe alcoholism continues. By this point the alcoholic’s brain has become dependent on alcohol to function properly. When the addicted individual ceases consuming alcohol, the brain is thrown into disarray. This causes Alcohol Withdrawal Syndrome (AWS). Alcohol withdrawal can be extremely painful, cause seizures, restlessness, hallucinations, nightmares, heart palpitations, and vomiting, among other unpleasant effects. In some cases, alcohol withdrawal can even be fatal.
Various Benzodiazepines help reduce the impact of Alcohol Withdrawal Syndrome in a number of ways. Some of the symptoms Benzodiazepines treat include:
- Seizures and tremors
- Difficulty sleeping and restlessness
- Nausea and vomiting
- Chills and sweats
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Benzodiazepines Commonly Used to Treat Alcohol Withdrawal
Proper Use of Benzodiazepines
Benzodiazepines carry a number of side effects, including addiction. Additionally, some may cause reactions when used in combination with other alcohol treatment medications. For these reasons, they should only be taken under the supervision and prescription of a licensed medical professional, preferably within an inpatient alcohol detox and rehabilitation setting. However, they are frequently prescribed successfully in outpatient settings as well.
The type of Benzodiazepine prescribed and the manner in which it is used will vary depending on a number of factors, including the setting of use, the severity of the alcoholism issue, and the symptoms presenting themselves during detox. In general, Benzodiazepines are used in three ways.
Fixed Tapering Dose Regimen (FTDR)
- Fixed dose not adjusted based on symptom severity
- Best suited for mild symptoms
- Ideal for outpatient recovery
Symptom Triggered Regimen (STR)
- Dosage is based on patient’s rating of pain – higher levels of pain get higher dosage
- Suited for mild to very severe symptoms
- Can only be utilized under direct medical supervision
- Only used in inpatient recovery
Loading Dose Regimen (LDR)
- Uses long-acting Benzodiazepines that stay in the body for several days
- Most impactful at reducing seizures
- Ideally only used in inpatient settings to allow monitoring
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Side Effects of Benzodiazepines
Different Benzodiazepines have different side effects; some of which are mild, and some of which are very severe. A challenge is that many Benzodiazepine side effects mirror symptoms of Alcohol Withdrawal Syndrome, making it difficult to tell what is actually the cause. Some common side effects of Benzodiazepines include:
- Drowsiness and sedation
- Confusion and lightheadedness
- Nausea and vomiting
- Constipation and memory loss
- Change in appetite
- Difficulty maintaining balance
- Weight gain
- Sexual malfunction
Less common, but more severe, side effects of Benzodiazepines include:
- Increased and decreased heart rate
- Movement disorders
- Respiratory issues
- Reactions with other medications
Benefits of Benzodiazepines
- Offer a wide variety of options to choose from so that each individual case can be treated in an appropriate manner
- Help counteract the most severe and dangerous symptoms of Alcohol Withdrawal, especially pain and seizures
- In some cases, present fewer and less severe side effects than alternative medications
- Make it possible for some alcoholics to overcome the worst symptoms of withdrawal successfully so that they can start on longer term recovery
Alcoholism is a very serious addiction, and it can be very difficult to overcome. This is especially true during alcohol withdrawal, a potentially dangerous time that should be monitored by medical professionals. If you or a loved one are struggling to overcome alcoholism, you don’t need to do it alone. Contact a dedicated treatment specialist now to find out what treatment options are available.
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