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Alcohol Withdrawal Information
Alcohol withdrawal is a set of symptoms that occur with the elimination of alcohol when a
person is psychologically and/or physiologically addicted to it.
A majority of people who have been drinking alcohol and decide to stop (often for
health-related reasons) are able to do so without much trouble. Alcohol withdrawal typically
becomes difficult only when problem drinkers—alcoholics—attempt to quit. Almost
inevitably, alcoholics need help in achieving this goal. Sometimes, this help requires medical
intervention in detoxification centers.
Finding doctors who work with alcohol detoxification is often as easy as calling the local
chapter of Alcoholics Anonymous (AA) and asking for referral information. Most programs
successful in getting alcoholics to quit drinking are either part of the AA network or employ
AA techniques. Natural approaches to alcohol withdrawal should not be a substitute for detox
centers or for AA or AA-related programs.
What are the symptoms of alcohol withdrawal?
A person typically has a mild to severe hangover that lasts several days. Symptoms may
include stomach upset; headache; shakes or
jitters; feelings of generalized anxiety or
panic attacks; and insomnia that may be
accompanied by bad dreams. There may be also be increases in heart rate, breathing rate, and
body temperature. In a small proportion of alcoholics, withdrawal may result in severe
symptoms, such as hallucinations, delirium tremens (DTs), or generalized seizures.
Medical treatments for alcohol withdrawal
Over the counter treatment involves supplementing with multiple B vitamins, including thiamine.
Prescription treatments in detoxification centers may begin with an injection of vitamin B1 in cases that involve malnutrition. In
treating severe acute withdrawal symptoms, a nervous system depressant, such as the benzodiazepines such as diazepam (Valium®) and
lorazepam (Ativan®), is prescribed with a dosage that is tapered down over three to five
days. The beta-adrenergic blocking drugs atenolol (Tenormin®) and propranolol (Inderal®) are also occasionally
used.
Further treatment includes adequate nutrition, fluid intake, and rest.
Dietary changes that may be helpful for alcohol withdrawal
Some of the nutritional deficiencies associated with alcoholism can be caused by a poor
diet—a factor that needs correction on an individual basis. Improving the overall diet
should be done in conjunction with a doctor. Sometimes liver or pancreatic disease associated with alcoholism
also contributes to nutritional deficiencies. These problems require medical assessment and
intervention.
In one trial, a hospital diet was compared with a special diet including fruit and wheat germ and excluding caffeinated coffee, junk food, dairy products, and peanut butter.1 After six months, fewer
than 38% of those on the hospital diet remained sober, compared with over 81% of those eating
the special diet. A review of the research shows that diets loaded with junk food increase
alcohol intake in animals.2 In a human trial, restricting sugar, increasing complex carbohydrates, and
eliminating caffeine also led to a reduction
in alcohol craving.3 While the support for dietary intervention remains somewhat
unclear, some doctors suggest that alcoholics reduce sugar and junk food intake and avoid
caffeine.
Lifestyle changes that may be helpful for alcohol withdrawal
Most experts agree that alcoholics must stop drinking completely in order to overcome the
addiction. Moreover, before nutritional supplements can be used, effective treatment of the malabsorption problems requires a complete
avoidance of alcohol.
Nutritional supplements that may be helpful for alcohol withdrawal
Many alcoholics are deficient in B vitamins, including vitamin B3. John Cleary, M.D., observed that some
alcoholics spontaneously stopped drinking in association with taking niacin supplements
(niacin is a form of vitamin B3). Cleary concluded that alcoholism might be a manifestation of
niacin deficiency in some people and recommended that alcoholics consider supplementation with
500 mg of niacin per day.4 Without specifying the amount of niacin used,
Cleary’s preliminary research findings suggested that niacin supplementation helped wean
some alcoholics away from alcohol.5 Activated vitamin B3 used intravenously has
also helped alcoholics quit drinking.6 Niacinamide—a safer form of the same
vitamin—might have similar actions and has been reported to improve alcohol metabolism
in animals.7
Deficiencies of other B-complex vitamins
are common with chronic alcohol use.8 The situation is exacerbated by the fact that
alcoholics have an increased need for B vitamins.9 It is possible that successful
treatment of B-complex vitamin deficiencies may actually reduce alcohol cravings, because
animals crave alcohol when fed a B-complex-deficient diet.10 Many doctors recommend
100 mg of B-complex vitamins per day.
Alcoholics may be deficient in a substance called prostaglandin E1 (PGE1) and in
gamma-linolenic acid (GLA), a precursor to PGE1.11 In a double-blind study of
alcoholics who were in a detoxification program, supplementation with 4 grams per day of evening primrose oil (containing 360 mg of GLA)
led to greater improvement than did placebo in some, but not all, parameters of liver
function.12
The daily combination of 3 grams of vitamin
C, 3 grams of niacin, 600 mg of vitamin B6, and 600 IU of vitamin E has been used by researchers from the
University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics.13 Although the
effect of vitamin supplementation was no better than placebo in treating alcohol-associated
depression, the vitamins did result in a significant drop in anxiety within three weeks of
use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin
B6 must do so only under the care of a doctor.
Although the incidence of B-complex deficiencies is known to be high in alcoholics, the
incidence of other vitamin deficiencies remains less clear.14 Nonetheless,
deficiencies of vitamin A, vitamin D, vitamin E, and vitamin C are seen in many alcoholics. While some
reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,15
potential problems accompany the use of either vitamin A or beta-carotene in correcting the
deficiency induced by alcoholism.16 These problems result in part because the
combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase
potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor̵
Herbs that may be helpful for alcohol withdrawal
Milk thistle extract is commonly
recommended to counteract the harmful effects of alcohol on the liver.22 Milk
thistle extracts have been shown in one double-blind study to reduce death due to
alcohol-induced cirrhosis of the
liver,23 though another double-blind study did not confirm this
finding.24 Milk thistle extract may protect the cells of the liver by both blocking
the entrance of harmful toxins and helping remove these toxins from the liver
cells.25 26 Milk thistle has also been reported to regenerate injured
liver cells.27
Kudzu is most famous as a quick-growing
weed in the southern United States. Alcoholic hamsters (one of the few animals to become so
besides humans) were found to have decreased interest in drinking when fed kudzu
extract.28 Traditional Chinese medicine practitioners generally recommend 3 to 5
grams of root three times per day; some herbal practitioners also suggest that 3 to 4 ml of
tincture taken three times per day may also be helpful to reduce alcohol cravings.
Nonetheless, a double-blind trial using 1.2 grams of powdered kudzu root twice per day failed
to show any benefit in helping alcoholics remain abstinent from alcohol.29
Are there any side effects or interactions with Alcohol Withdrawal?
Refer to the individual herb for information about any side effects or interactions.
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Copyright © 2004 Healthnotes, Inc. All rights reserved.
www.healthnotes.com
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about the authors of Healthnotes.
The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in
vitro), clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of
the conditions discussed, treatment with prescription or over the counter
medication is also available. Consult your doctor, practitioner, and/or
pharmacist for any health problem and before using any supplements or before
making any changes in prescribed medications.
References:
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