When Medication Is an Option
The foundation of understanding alcohol use disorder as a chronic disease is an important part of understanding why medication would be used to treat an addiction. AUD is more than casual or even heavy drinking. When the body is addicted to alcohol, willpower is no longer a viable strategy to use for becoming sober. For those who struggle with AUD, addiction ends up as a lack of control over decision-making with dangerous and sometimes deadly consequences. At this point, alcohol has changed the brain’s reward system, memory, and motivation. The body must detox and undergo changes to unlearn the patterns and decisions that were associated with alcohol addiction. Full recovery from this disease is a process, and the aid of medicine can be an effective way to go through that process successfully.
When it comes to detoxing from alcohol, one of the first places to start is to stop drinking alcohol altogether. Obviously, cutting off addiction and short-circuiting the changes that have taken place in the body can cause a wide range of withdrawal symptoms. The safest way for detox to take place is alongside medical professionals. One reason is that some alcohol withdrawal symptoms are dangerous to undergo alone. These can include seizures and delirium tremens (DTs), both of which can be life-threatening without medical treatment. Because alcohol is technically a central nervous system (CNS) depressant, not unlike the sedative Ambien and benzos like Xanax that manipulate the central nervous system, it carries some of the same withdrawal symptoms, such as anxiety, depression, and insomnia.
What Medicines Are used
Using medication for alcohol detox in a professional setting can provide the following benefits:
- Protect patients from life-threatening symptoms like seizures or DTs
- Help the brain gradually taper through the detox process instead of experiencing sudden shifts
- Ease uncomfortable withdrawal symptoms
- Provide an incentive to complete detox safely and completely, avoiding relapse.
So, which medications have proven the most effective to help achieve this? Surprisingly, benzodiazepines are among the most prescribed for alcohol withdrawal and detox. One reason for this is because of how versatile benzos are. Because every person is different, and each detox has its unique challenges, benzos can be adapted to treat their specific needs. They come in short-, intermediate-, and long-acting forms, so they can be adjusted to taper people through the withdrawal process effectively. Among these options, research points to diazepam (Valium) as the overall best option.
However, there is a downside to benzo use for alcohol detox. Benzodiazepines have been called the new opioids, and their black box warning label status from the Food and Drug Administration (FDA) has caused a great deal of concern over the high potential for addiction. While undergoing detox in a medical environment is the safest way to deter individuals from abusing benzos during alcohol withdrawal, benzos might not be the best treatment option for everyone.
Options beyond benzodiazepines might include anticonvulsant medications, barbiturates, and GABA (gamma-Aminobutyric acid) agonists. However, most of these are not effective in treating severe symptoms such as DTs. The exception to this is the drug gabapentin, which can control partial seizures and works in the brain to prevent seizures while taking the medication.
Risks and Warnings for Medicine and Alcohol
While the prospect of understanding what to take, when to take it, and why to take it seems overwhelming, it highlights just how powerful and helpful a professional detox can be. While users might be able to attempt an alcohol detox at home, doing so carries risks beyond the potentially severe side effects. Without a support system and dedicated professionals to monitor the detox, users are left to rely on their own willpower to go through the entire withdrawal process. But as noted earlier, willpower is not enough to deal with a complex disease like alcohol use disorder (AUD). When individuals go through detox with medical professionals, it opens up the possibility for constant evaluation, adjustments to medication based on progress, and the accountability of others who are there to help patients succeed.
While the risks associated with alcohol withdrawal medications should not be understated or overlooked, medical professionals can take these risks into consideration and modify them for each unique person. While the fear of trading an alcohol addiction for another drug addiction might stop some people from taking the first step to recovery, we should remember that these drugs are not a trade-off for alcohol. Instead, they keep the process moving in a positive direction toward recovery.
