Drugs used for alcohol detox

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If you are undergoing alcohol withdrawal, here is a list of drugs that you can use to alleviate discomfort and lessen the worsening symptoms, especially if you are at risk of severe alcohol withdrawal.

What are the drugs used for alcohol detox

For treating alcohol withdrawal syndrome

1. Benzodiazepines

This particular drug is prescribed to patients who are experiencing panic, anxiety, and certain types of seizures during alcohol withdrawal.

Benzodiazepines belong to sedative medications and it is the choice of drug for physicians for it can remarkably reduce the risk of seizure in people who are suffering from the symptoms of alcohol withdrawal.

The first-line of medications are long-acting benzodiazepines with active metabolites because they lessen the chance of seizures recurring.

On the other hand, short-acting benzodiazepines are prescribed for the withdrawal management of the elderly and people with chronic liver issues.

There are different types of benzodiazepines and some “Benzos” might even kill you

FDA-Approved Benzodiapenes

  • Chlordiazepoxide (Librium)
  • Diazepam (Valium)
  • Oxazepam (Serax)
  • Clorazepate (Tranxene)

2. Anticonvulsants

Besides using benzodiazepines, physicians may also give out anticonvulsants to manage acute alcohol withdrawal syndrome, but it is only a secondary option.

However, if the patient is already experiencing severe alcohol withdrawal, doctors automatically add anticonvulsant medications to their treatment program.

These anticonvulsants can be one of the following:

  • Carbamazepine (Tegretol)
  • Oxcarbazepine (Trileptal)
  • Gabapentin (Neurotonin)
  • Valproic Acid (Depakene)

3. Barbiturates

There are cases where the person who is experiencing alcohol withdrawal symptoms is resistant to benzodiazepines.

During these cases, doctors resort to the use of barbiturates which is another class of drugs that may be utilized to treat alcohol withdrawal symptoms.

Aside from that, barbiturates are also commonly used in the emergency departments and intensive care units whenever they are handling cases of severe alcohol withdrawal.

For treating alcohol relapse

1. Disulfiram (Antabuse)

This drug works by inhibiting an enzyme that is used by our body to metabolize alcohol.

If one is maintaining intake of disulfiram, he or she will experience unpleasant effect even with consuming only a small amount of alcohol.

These unpleasant effects can be felt as soon as ten minutes after consumption of alcohol substance and can include headache, flushing of the face, headache, sweating, nausea, vomiting, and blurred vision.

These symptoms can last for an hour or more.

In conclusion, this drug is utilized to discourage a drinker from drinking alcohol by associating drinking with negative effects.

2. Naltrexone (Vivitrol, Revia)

This drug is initially used to treat individuals who are abusing opioids. However, come 1994, it is approved by FDA to treat alcohol dependence.

Although the real way of how Naltrexone works in treating patients with alcohol dependence, can’t be identified.

There are various reports from patients who were successfully treated by the drug that this helped in reducing their urge to drink.

Aside from that, they also said that it interferes with their desire to continue drinking once they tasted alcohol.

3. Acamprosate (Campral)

This drug does not prevent symptoms of alcohol withdrawal but it can be used to restore the vigour and balance of a person's nervous system.

Aside from that, acamprosate is not digested by the liver so it is a drug of choice for patients with liver problem.

When Can I Start Taking Medications for Alcohol Addiction?

Addiction professionals recommend medications to be used only after patients have stopped drinking and are in the process of pursuing abstinence.

Doctors warn not to start medications for addiction on their own just to control urges.

In addition, some experts believe it is best not to take medications without advice and guidance from doctors.

Excessive drinkers often took to their self-medication for alcohol addiction because:

  • It’s less expensive for them.
  • Certain drugs help block the effects of alcohol on your body's receptors in the brain.
  • The medication helps people to drink less and experience fewer harmful side effects of drinking alcohol.
  • It helps to relieve your withdrawal symptoms.
  • It helps you feel better, including reducing anxiety and depression.

However, starting to take your medications without medical supervision is dangerous and costly.

Before beginning any of the medications, let a healthcare professional guide you through how to take the drugs safely and to avoid unnecessary side effects.

For example, the FDA’s adverse event report shows that any combination of blood pressure medications, anticonvulsants and opioids may increase the risk of having an alcohol-related death and heart attack.

Doctors can provide advice about the dosages of alcohol medications, safety instructions, as well as how to choose and keep medications in the correct setting.

They also recommend patients seek medical advice about alcohol dosage when stopping medications because their addiction could increase or become worse.

Drugs like benzodiazepines for depression, blood pressure medications for high blood pressure, and prescription medications for anxiety and depression should be used sparingly to prevent overdosage.

Medications may be used occasionally and at low doses.

If you are a heavy drinker with alcohol dependence, you should take drugs to curb alcohol addiction.

People who may not start taking medications without professional help are those:

  • Unaware of the severity of their addiction. If you don’t know the severity of your addiction, it’s unsafe to self-medicate yourself with anti-alcohol addiction drugs.
  •  Who have pre-existing conditions with medicines. If you have a medical condition, medications may be prescribed to treat health issues. However, some pre-existing medications might interfere with your alcohol treatment meds. So, it's best to consult with a doctor before mixing all medications.
  • Who are currently drinking and have a high probability of relapse. Mixing alcohol and medications have adverse effects on the body.

The use of alcoholism medications is not suggested while the patient is still consuming alcohol since this may have harmful side effects that might lead to withdrawal or impede the patient's development.

The psychological effects of alcohol addiction medications aid in the transformation of not desiring to drink anymore, or at the very least, being clean for a long time.

As a result, it's critical that the person is already sober and abstaining for a long time, or else it may be misinterpreted as withdrawal.

People who would like to take medication must have gone through alcohol abstinence, without any experiences of withdrawal symptoms, for the medications to fully function and not have any chemical reaction.

Can Medications Be Used After Detox?

Recovering from alcohol addiction takes a relatively long process because of the chemical reactions you have to watch out for. In terms of medications, consuming it shouldn’t be done just at any given time.

It is most definitely recommended for medications to be used after successful detoxification or abstinence, and not during the very process of it.

'Drug Detoxification' as a concept is used to allow patients struggling with alcoholism to stabilize their bodies first before going into medication. Detoxification is directly associated with physiological healing before psychological and behavioural changes can occur.

It is dangerous for patients struggling with alcohol addiction to go into medication without yet being abstinent or fully detoxed because this may cause chemical reactions to their body.

Patients who have not yet fully detoxed and resort to medications may experience different effects, depending on the medication being taken.

In worst-case scenarios, this can also worsen their physical dependency because of the chemical reactions brought about by the mixture of alcohol and the medication.

Most medications are not prescribed before detoxification because of the varying effects that can happen. The process of detoxification may also be done at home, but studies have shown that better results are obtained with the help of licensed professionals that work in detoxification centres and similar healthcare facilities.

The main difference between detoxification at home and in licensed healthcare facilities is the capacity of these centres to attend to patients that may experience withdrawal symptoms.

Unlike in a home set-up, not all people are aware of the necessary steps needed to manage such symptoms.

The usual and recommended detoxification process involves the following:

  • Monitoring & Evaluation
  • Continual Abstinence & Stabilization
  • Preparation for Therapy

Monitoring and evaluation is the stage in the road of detoxification which allows healthcare professionals to assess the patient’s ability to move forward with using medication.

There are times that abstinence can be successful. However, with patients’ changing lifestyles and behaviours, withdrawals are still possible.

Additionally, since medications have different effects on different people, this will aid doctors in knowing which medications are most effective for the individual.

With continuous abstinence and stabilization, medications can already be administered. In this period, detoxification has already been finished, and the medications can be most efficacious.

This stage also allows the patient's body and mind to lessen dependency and improve the tendency to fall back into the withdrawal symptoms.

If withdrawal symptoms occur, varying treatments may be conducted to meet the body's capacity and the patient's lifestyle.

Moving forward, preparation for therapy is most successful after the process of stabilization and abstinence have been long achieved.

In this stage of expected and assumed detoxification, medications are usually taken to lessen the symptoms and ameliorate the continuous process of detoxification.

Common medicines that help with the detoxification process include antidepressants, opioid antagonists, and benzodiazepines.

In Summary

Medications are okay to be taken after detoxification. It is more recommended to take such drugs after the detoxification process to lessen potential reactions to the body that is caused by the mixture of alcohol and the medication.

The key to getting sober, professional medical detox is the safest alternative. At Abbeycare Scotland or Abbeycare Gloucester, we prescribe and monitor patients to guarantee that their medications are handled for their wellbeing.

Last Updated: June 14, 2021

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.