Alcohol Dependence And Withdrawal

WHAT YOU SHOULD KNOW:

  • Alcohol dependence , also known as alcoholism, is a type of alcohol use disorder. Alcohol is found in beer, wine, liquor, such as vodka and whiskey, and other adult drinks. With alcohol dependence, you drink alcohol too much and too often for a long period of time. You have a continuous craving for alcohol, making it hard to do your usual day-to-day activities. You will be diagnosed with alcohol dependence if you have at least three alcohol dependence symptoms within a year. These include needing more alcohol to get the same effects, and having symptoms of withdrawal if you stop drinking. You may also want to, but be unable to control your drinking. You may also drink even when you know that you have alcohol-related health problems.

  • Alcohol withdrawal occurs when you stop drinking, or you drink less while having alcohol dependence. Symptoms begin as your body tries to get used to this change. You will be diagnosed with alcohol withdrawal if you have at least two symptoms after you limit or stop drinking. Common symptoms include shaking, throwing up, and sweating. These symptoms may make you anxious and unable to work or be around others. Symptoms occur within several hours to a few days after stopping alcohol, and are not caused by other health problems.

  • Treatment for alcohol dependence and withdrawal includes medicines, detoxification, and therapy. Diagnosing and treating alcohol dependence and withdrawal as soon as possible may relieve or prevent symptoms. With treatment and care, your alcohol dependence and withdrawal may be controlled, and your quality of life improved.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Treatment for alcohol dependence may cause unwanted side effects. Some medicines may cause you to have headache, nausea (upset stomach), vomiting (throwing up), or a faster heartbeat. Other side effects include loss of appetite, anxiety, or drowsiness. If left untreated, your drinking problem may get worse and you may develop other serious problems. These include high blood pressure, and liver, brain, heart, lung, or kidney diseases. You may have problems with your moods, friendships, and relationships. You also increase your chance of having accidents, harming others, or breaking the law.

  • With alcohol withdrawal, some medicines may also cause sleeping problems, unusual changes in behavior, or low blood pressure. Alcohol withdrawal, if not treated, may be life-threatening and cause damage to your brain, liver, lungs, heart, and kidneys. These may lead to convulsions, heart attacks, stroke, or even death. The earlier alcohol dependence and withdrawal are treated, the better the chances of preventing future problems. Your health, quality of life, and ability to function may decrease without treatment. Ask your caregivers if you are worried or have questions about your condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Psychiatric Assessment:

Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed when you needed it. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. The answers to these questions can help caregivers decide on your treatment. Caregivers will ask you about factors that can help you during treatment. These factors may include how you feel about treatment and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.

Activity:

At first you may need to rest in bed and have plenty of sleep. You may also have to stay in an evenly lit and quiet room. Loud noises, bright lights, or other disturbing things should be avoided while you are resting. If you have trouble breathing or chest pains, call your caregiver right away.

Intake and output:

For intake and output (I and O), caregivers will keep track of the amount of liquid you are getting. They may also need to know how much you are urinating. Men 19 years old and older should drink about 3 liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2 liters of liquid each day (close to 9 eight-ounce cups). Certain foods also contain liquid. You may need to have more or less liquid each day. Ask your caregiver how much liquid you should have each day. Ask caregivers if they need to measure or collect your urine before you dispose of it.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may need any of the following:

  • Alcohol dependence: Your caregiver may suggest certain medicines to help you control your alcohol dependence and other related problems. Ask your caregiver for more information about these medicines.

  • Alcohol withdrawal:

    • Anticonvulsant medicine: Anticonvulsants are given to control seizures.

    • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up).

    • Blood pressure medicine: This medicine may be given to lower your blood pressure. Keeping your blood pressure under control protects your heart, lungs, brain, kidneys, and other organs.

    • Sedative: A sedative medicine may be given to help you stay calm and relaxed.

    • Sympatholytics: These medicines are usually used to control high blood pressure and other signs and symptoms of alcohol withdrawal. They may also be used to help decrease shakiness or uncontrolled movements. Sympatholytics may help you feel calmer, more focused, and less irritable.

  • Other medicines:

    • Glucose: This medicine may be given to increase the amount of sugar in your blood.

    • Mineral and vitamin supplements: Mineral and vitamin supplements, such as Vitamin B1 or thiamine, may be given. This helps prevent other alcohol-related conditions that may affect the brain.

Tests:

You may need any of the following:

  • 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by cleaning it or removing hair. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is attached to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.

  • Blood, urine, saliva, or breath tests: Samples of your blood, urine, or saliva are collected and sent to a lab for tests. Your breath may also be tested to check the levels of alcohol.

  • CT scan:

    • This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.

    • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

  • Magnetic Resonance Imaging: This test is called an MRI. During the MRI, pictures are taken of your head. An MRI may be used to look at your brain, muscles, joints, bones, or blood vessels. You will need to lay still during an MRI. Never enter the MRI room with any metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

  • Neurologic signs: Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check your eyes, your memory, and how easily you wake up. Your hand grasp and balance may also be tested. This helps tell caregivers how your brain is working after an injury or illness. You may need to have your neuro signs checked often. Your caregiver may even have to wake you up to check your neuro signs.

Treatment options:

Your may need any of the following:

  • Detoxification: Your caregiver may need to put you in an alcohol detoxification program or detox. This is done to flush out the toxic residues of alcohol present in your body. During detox, medicines are given to help prevent withdrawal symptoms when you stop drinking alcohol. As you improve, your caregiver may slowly change how much detox medicines you are given.

  • Respiratory support:

    • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

    • Ventilator: A ventilator is a special machine that can breathe for you if you cannot breathe well on your own. You may have an endotracheal tube (ET tube) in your mouth or nose. A tube called a trach may go into an incision (cut) in the front of your neck. The ET tube or trach is hooked to the ventilator. The ventilator can also give oxygen to you.

  • Therapies:

    • Cognitive behavioral therapy: With a therapist, you will learn how to control your actions and improve your behavior. This is done by teaching you how to change your behavior by looking at the results of your actions. You may also need to know how to cope with situations which make you depend on alcohol use.

    • Motivational enhancement therapy: Motivational enhancement therapy is used to encourage you to stop using alcohol. A therapist or counselor motivates and helps you set goals so you may change your destructive behaviors. By doing these changes, you may stop depending on alcohol and have a better lifestyle.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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