Alcohol withdrawal

Alcohol withdrawal is an actual diagnosis contained in the American Psychiatric Association's Diagnostic and Statistical Manual - IV (DSM IV). Alcohol withdrawal can be mild, moderate, or severe. The moderate and severe withdrawal may require intense medical treatment.

Alcohol consumption that is heavy and prolonged will cause a withdrawal syndrome if alcohol consumption is reduced or stopped altogether. The withdrawal syndrome usually starts six to twenty-four hours after the last drink and may start prior to the blood alcohol level returning to zero.

The DSM - IV requires that two of the following criteria be met to diagnose someone with Alcohol Withdrawal who has been consuming alcohol in a heavy and prolonged manner:

1. Sweating, also known as diaphoresis. Most people who complain of sweating complain of night sweats. 
2. Pulse rate greater than 100. This may be referred to Tachycardia,
3. Increased hand tremor.
4. Insomnia or sleeplessness. 
5. Nausea or vomiting.
6. Transient (on and off) visual, tactile, or auditory hallucinations or illusions.
7. Psychomotor agitation
8. Anxiety
9. Grand mal seizures

A further requirement is the symptoms above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. A further requirement is the symptoms are not caused by another medical concern (ie Parkinsons) or another mental disorder.

A way to quantify or measure the withdrawal symptoms and place some type of severity scale to the symptoms is to use the Clinical Institute Withdrawal Assessment - Alcohol, or CIWA. Executive Home Detox does use the CIWA scale when assessing clients during an alcohol detox. The expert nurse also monitors vital signs, specifically Temperature, Blood Pressure, Pulse rate, and Respirations.

A future blog will discuss the CIWA in greater detail.

The Principles of Addiction Medicine, Fourth Edition was utilized as a reference for much of the information above.