Alcohol withdrawal syndrome
Withdrawal syndrome is a typical condition of the middle stage of alcoholism. It is a hangover by the nature, but it differs from the usual hangover which is experienced by healthy people in the morning after outdrink eve. Translation of the term (abstinentia) means abstaining. It arises for the drinker shortly after alcohol dose reduction or cessation of drinking alcohol.
Only alcoholics have this syndrome, and it is a clear sign of alcoholism. If a person has this syndrome, it means that he is an alcoholic.
A healthy person in the usual hangover in the morning has a headache, nausea, sometimes — vomiting, shaky hands. However, these symptoms usually disappear by lunchtime. This condition should not be confused with pathological withdrawal syndrome, which lasts much longer, from 3 to 5 days. The causes of ailment are similar for both cases: the accumulation of toxins and decay products of alcohol in the blood; an alcoholic has the symptoms of withdrawal syndrome burdened with disorders of functions of heart, brain, liver, pancreas, and the poor condition of the blood vessels.
In the presence of withdrawal syndrome the alcoholic have quickening of pulse, the breathing becomes more frequent, the body temperature can increase and chills may occur. Man loses his appetite, and his face complexion is getting sallowed. The arterial pressure of the patient may increase or, conversely, decrease. Often diarrhea and vomiting appear. The patient has motor dysfunction; the muscle tone is getting reduced.
The most severe is the withdrawal syndrome that has developed after a long binge. In the first three days after the cessation of alcohol intake the patient may have single or serial convulsionary attacks, which involve biting tongue and peeing.
This syndrome usually goes away after a few days, but alcoholics rarely bear the test not to drink again these days. And he not only drinks, but also gets seriously drunk. The newly-taken alcohol eases the withdrawal symptoms and alcoholic feels better. Abstinence syndrome within the alcoholism lasts not more than 5 days because the organism is recovering during this time, so that complaints related to the hangover usually disappear. And also because it usually ends with psychosis, which is popularly called delirium tremens.
Alcohol withdrawal syndrome can be distinguished from the usual hangover by the severity. If a healthy person in the state of usual hangover feels unwell, then an alcoholic in the same situation feels completely overwhelmed. He has not only shaky hands, but is shivering from head to foot.
Severe withdrawal precipitations
If the state of alcoholic with withdrawal syndrome is not too heavy, vomiting may not occur, but in more severe cases, the patient suffers from very severe vomiting. Vomit contains not only the debris of food from the stomach, but also bile from the duodenum. Often in such a vomiting the blood is present. This is a red flag, because further the profuse gastric bleeding may happen when blood is literally squirting. In this case, in order to save the patient he needs the emergency surgery.
Where from comes the blood in the vomit of alcoholic? It comes from the burst thinned out blood vessels and varicose veins of the esophagus and stomach. Such varices is a consequence of progressive liver cirrhosis of the patients with alcoholism.
2. Exacerbation of hemorrhoids.
In most cases, withdrawal syndrome is accompanied with exacerbation of hemorrhoids. It is an extension and burst of varicose vessels of the rectum, overflowing with venous blood.
3. Intraintestinal bleeding.
Black feces is a symptom of intraintestinal bleeding. If the patient’s feces has a color of coal, the relatives should immediately call an emergency ambulance, because it is a life-threatening situation for the one who’s suffering from alcoholism.
The headache is a rare within the withdrawal syndrome, but if it bothers the patient, the cause may be old injuries and increased intracranial pressure, as well as exacerbation of hypertension.
5. Insomnia and nightmares.
Alcohol withdrawal syndrome leads to persistent insomnia, where the patient is harassed by the nightmares. If such a condition lasts for about 5 days, there may appear deceptive visual and audio perceptions. For example, in the clamour of the wheels of the train the patient can hear the death threats directed against him, and he may perceive a usual coat on a hanger in the hallway as a man who’s hiding in the dark. A man may think that he is falling somewhere… In his dreams he becomes painful participant of harassment acts, car chases and attacks scenes. The diseased suffering of withdrawal syndrome often has nightmares where the animals are present.
The deceptive perceptions which continue for a long time usually lead to the development of delirium tremens, or alcohol delirium. At that, hallucinations completely fill the mind of alcoholic and substitute a real visual and audio information.
6. Exacerbation of existing diseases.
Within the alcohol withdrawal syndrome, which is dangerous because of internal bleeding and mental disorders, the old diseases from which the patient previously suffered, are exacerbating. Moreover, alcoholism leads to the development of new diseases.
Characteristic diseased of alcoholics are acute and chronic pancreatitis, wherein there is pain in the lumbus and under the ribs on the left side; liver diseases — alcoholic hepatitis and cirrhosis — in such cases, the patient feels pain in the right hypochondrium. And in fact, in both cases it is necessary to apply primarily to narcologist.
7. Cerebral edema.
Life-threatening complication of alcohol withdrawal syndrome is cerebral edema, which affects the respiratory and cardiac centers. Cerebral edema almost always leads to death of the patient-alcoholic.
In general, the alcoholic has no healthy organs. In one or another way the addiction to alcohol affects the entire organism of the patient. Those suffering from alcoholism men with hangover have significantly reduced attention. It is unstable, and alcoholic cannot concentrate. The mental activity of the organism is also in disorder, and if alcoholic has a bad mood, it exacerbates the situation.
The alcoholic has significantly reduced memory span, provided that both short-term and long-term memory suffer. Some patients are more likely to retain the logical memory, and some – mechanical one.
Thought process disorder of alcoholics during withdrawal syndrome
People who abuse alcohol, have a thinking where many different alcohol associations arise easily. This is happening due to the intense craving for alcohol, which is distorting the feelings and desires of a drinker. His basic social and spiritual values are distorted.
The thinking of alcoholic is unproductive, it lacks creativity and humor. The dynamics of mental processes is severely impaired, so alcoholics do not learn instructions well; their responses are often absurd and ridiculous, and associations are random and shallow. The more severe is withdrawal syndrome, the more disorganized is the thinking of an alcoholic. Within a large «term» of alcoholism, the thinking process of alcoholic is characterized by special deceleration and inertia.
Mental disorders within withdrawal syndrome have features of disturbing sadness, dysphoric and apathetic subdepression. If the age of an alcoholic is less than 35 years, he would have more pronounced anxiety, and if he is over the age of 35, then the depressed mood prevails.
In the dreary mood alcoholics are blaming themselves for the harmful addiction and actions performed by them in a state of intoxication. Various life situations exacerbate the patient’s low mood. The feeling o frustration sometimes pushes these people to committing suicide, although many such cases have a demonstratively-blackmailing nature. For example, if an alcoholic is seeking money from his relatives for another dose of alcohol.
In the hard anxious mood an alcoholic is afraid to die because of the heart failure. Such patients often call in a doctor, so that he appointed them some cardiovascular drugs. Sometimes such anxiety leads to the feeling of shortness of breath. Abstinence syndrome within alcoholism not only includes anxiety disorders, but can also provoke panic attacks.
Alcoholic’s attraction to the state of intoxication may become stronger within a hangover. To satisfy it, the patient is ready to sell for a penny all that he has, he escape from his family by coming down from the balcony on bed sheets or on the ropes, and even commit a crime.
But in other cases, on the contrary, the craving for alcohol is lost, and the patient has an aversion to the smell and even view of an alcohol. It’s a sign of the reverse development of withdrawal syndrome, in which the night’s sleep of the patient improves, and affective disorders disappear or become less severe. The most long-lasting in this case are neurological symptoms — a violation of muscle tone and the trunk ataxia.
Help to the patient with alcohol withdrawal syndrome
How to remove the withdrawal syndrome? The qualified narcologist can remove withdrawal symptoms if the patient is suffering from alcohol dependence, if it did not yet cause complications of the disease. The best way to treat the withdrawal syndrome of alcoholism is the drug abuse clinic, where a patient is under constant medical supervision of medical staff.
Treatment of withdrawal syndrome at home is fraught with serious complications for the patient. In addition, for the relatives of an alcoholic it is very difficult to monitor the patient’s compliance to sober lifestyle at home, though it’s a “must comply” condition for the treatment of this disease.
In most cases, in the clinic the treatment of alcohol withdrawal syndrome starts with the intravenous polyionic saline solution administration into the patient’s organism; this leads to settling normal electrolytic balance. To the solution which is administered intravenously, also are added soothing, cardiac, sleep-inducing, vasodilators, diuretics and other medicines.
After throw off the hangover the mental activity of the patient begins to recover. The terms of its restoration to normal depends on the severity of the came through withdrawal symptoms, and even more — from the duration of the disease, which determines the depth of encephalopathic disorders. Many patients face improvement of the memory, diminishing of the craving for alcohol and fewer alcoholic associations.
Jugulation of withdrawal syndrome can completely restore the social and moral values of the patient that have been distorted due to the harmful addiction to alcohol. In such cases, the alcoholic deformation of the personality can be assumed a temporary state, which goes away after the treatment.
If the withdrawal symptoms have disappeared, but these disorders persist, it means that there appeared the degradation of the personality of alcoholic. In this case, the patient meets such thought disorders as the inability of the main and secondary differentiation, reduced ability to abstract information, penchant for details, non-censoriousness and lack of productive thinking.
What regards the self-esteem of an alcoholic, it varies with his personality, duration of the disease, depth of personality changes, and while being in the withdrawal syndrome – it depends mainly on the structure and the depth of the depression.
Whatever the outcome of the treatment is, if the patient will continue to drink alcohol, the withdrawal symptoms will repeat again and again. Alcoholism is a disease that has no reverse development. Therefore, one can break the tether of all its symptoms only by complete alcohol cessation.