By Margaret Kohut, MSW Master Addiction Counselor (Ret.)
If you’ve decided to stop using alcohol after a year or more of daily, heavy use, you should talk with your health care provider about how to manage your withdrawal syndrome. Yes, you will have withdrawal symptoms; how serious they are and how they’re managed is up to you and your provider. You’ve read other posts where I’ve commented about how dangerous it is to stop drinking “cold turkey” and I’d advise you to review those posts now, before you read this post any further.
Done? Okay, now you’re ready to express your concerns about why and how someone is withdrawn from alcohol as either an outpatient or an inpatient. Although the following is by no means all-inclusive, here are some general guidelines that your health care practitioner can discuss with you:
- You can probably be safely withdrawn from alcohol as an outpatient if you have no history of seizures, no history of uncontrolled high blood pressure, and no present chronic and/or serious medical conditions. If you live alone, you should have someone whom you trust come and stay with you for a week in case of a withdrawal complication.
- You should probably be withdrawn as an inpatient if you have a seizure disorder, a history of high blood pressure, a serious mental health disorder like schizophrenia, or are currently suffering from a chronic and/or serious physical condition.
Let’s take a look more closely about how alcohol is usually medically managed. First, it’s very likely that you are going to have cravings for alcohol, both physically and emotionally. In the US, alcohol cravings are greatly diminished through a drug called Campral (ask your practitioner what it’s called in your country). To prevent relapse, Campral is usually taken for about a month – longer, if necessary.
For the anxiety and insomnia that can occur with alcohol cessation, your medical provider has a variety of options including (these are US trade names) Buspar, an all-around anxiety reducer, or minor tranquilizers of the benzodiazepine class like Valium, Ativan, Klonopin or Xanax. Although if taken long-term the benzodiazepines are highly and dangerously addictive, short-term use for alcohol withdrawal is completely safe for most people. They also can cause drowsiness and can help you sleep. If you have insomnia but are relatively un-anxious, Ambien is excellent in the short-term.
You’ve read, by now, that sudden alcohol cessation can cause seizures that may be fatal. If you have a seizure disorder, you must let your medical provider help you withdraw safely from alcohol as an inpatient. Failure to do so could cost you your life. A primary cause of withdrawal-related seizures is high blood pressure – something people often don’t even realize they have. If you have no history of hypertension, your practitioner will probably give you a prescription for a drug like Clonidine to keep your blood pressure under control while you’re withdrawing from alcohol.
If you have a debilitating physical illness or handicap, or a severe mental illness, your medical provider will probably recommend that you withdraw safely from alcohol as an inpatient. In fact, there’s really no good reason why you should even have to stop drinking as an outpatient. The bad old days of “white- knuckles withdrawal” are long gone, and if you don’t have medical insurance, there are a great number of excellent low to no-cost detoxification clinics.
If I were to list all the medical alcohol withdrawal protocols in this post, it would be very, very lengthy and rather inaccurate since I’m not a physician. That’s why it’s important that you discuss your recovery options with a competent medical provider who knows you, and who knows the correct manner in which you should be withdrawn.
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