Alcohol Withdrawal Syndrome

Alcohol Withdrawal Syndrome Symptoms


Alcohol Withdrawal Syndrome

Alcohol Withdrawal Syndrome Introduction:-

  • Substance use disorder is due to substance use refers to Alcohol abuse, Psychoactive drugs, and other Chemicals.
  • Substance use disorder is an addiction disorder in which patients physiologic and psychological dependence on alcohol or other drugs, that are affect the central Nervous System.
  • Substance abuse is referred to a repeated taking of a substance.

Classification of alcoholism –

A/c to ICD-10

  • F10-F19 Mental and behavior disorder due to psychoactive substance use.
  • F10 – Mental and behavior disorder due to use of alcohol
  • F11 – Mental and behavioral disorder due to the use of opioids
  • F12 – Mental and behavioral disorder due to the use of Cannabinoids
  • F13 – Mental and behavioral disorder due to use of Sedative
  • F14 – Mental and behavioral disorder due to use of cocaine
  • F16 – Mental and behavioral disorder due to use of Hallucinogens.

Psychoactive Substance Drugs

  1. Sedative Drugs
  • Alcohol
  • Narcotics
  • Barbiturates
  • Benzodiazepines
  1. Stimulant drugs
  • Cocaine
  • Nicotine
  • Caffeine
  1. Hallucinogens
  • LSD
  • PCP

Alcohol Dependence Syndrome

  • Alcoholism is a disorder in which a patient feels physical and psychological dependence on alcohol and express the withdrawal symptoms after discontinue the alcohol.
  • Alcoholism is indicated the excessive use of alcohol to the point of causing and affect the individual, society and both.
  • Alcoholic patient commonest physically depend on alcohol

Cause of Alcohol Dependence

  1. Psychological cause – 
  • Stress, anxiety, depression
  • Failure in Exam
  • Low self-esteem
  • Poor impulsive control
  • Frustration and depression
  1. Social Cause – 
  • Religious factors
  • Social status and pear pressure
  • Easily available of alcohol
  • Family and occupational tension
  • Urbanization
  1. Biological factor – 
  • Alcoholic family
  • Family support
  • Social unsuccessful
  • Less satisfaction in social relationships.
  1. Environmental factors
  2. Hereditary.


Signs and symptoms of alcoholism

  • Euphoria
  • Dipsomania
  • Nutritional deficiency
  • Poor personal hygiene and untreated injuries
  • Increase tolerance capacity
  • Increase self-confidence
  • Violence behavior and the use of abusive words
  • Abnormal movement during walking
  • Slurred speech
  • Erectile dysfunction
  • Psychiatric disorder due to Alcohol Dependence
  1. Impaired attention or memory
  2. Inappropriate sexual or aggressive behavior
  3. Impaired judgment capacity
  4. Delirium Tremors
  5. Impaired psycho-Sexual function
  6. Alcoholic hallucinations.

Diagnosis of Alcohol Withdrawal Syndrome:-

  1. Screening test –

  2. Use the CAGE questionnaires, which were given by John Ewing.
  • C – Cut down the quantity of alcohol
  • A – Annoyed
  • G Guilt
  • E Eye opener (do you need alcohol at awakening time)
  1. GGT Test (Gamma-glutamyl transpeptidase test)

  • Normal GGT Value – 9-48 I.U.
  • Increase the level in liver in chronic alcoholic patient.
  1. Blood alcohol level assess
  2. Liver function test
  3. ECG, 2-D ECHO

Best Treatment for Alcohol Withdrawal Syndrome

  1. Self-control is the best management.
  2. Alcoholic anonymous (Self-help group meeting is arranged by the group of alcoholic patients)
  3. The drug of choice of alcohol withdrawal symptoms is a benzodiazepine
  4. Group psychotherapy
  5. Disulfiram drug is used for aversion therapy
  6. Disulfiram is contraindicated in cardiac and pulmonary disease patient.
  7. Anticonvulsants
  8. Psychological treatment
  • Group therapy
  • Motivational interviews
  • Cognitive behavior therapy
  • Relaxation training
  • Aversion conditioning therapy

Complication of alcoholism

  1. The physical complication of Alcoholism– 
  • Liver cancer and Liver Cirrhosis
  • Fracture and injury
  1. Social complications of Alcoholism –
  • Social withdrawal
  • Financial crisis
  • Violence
  • Divorce and family broken
  • Loss the self-status in society
  • Economic crisis and loss of job.
  1. Psychological Complication- 
  • 6th cranial nerve palsy
  • 3rd Cranial nerve palsy
  1. Wernicke Korsakoff Syndrome – 

These syndromes occur due to deficiency of Vitamin B(Thiamine) and chronic alcoholic patients.

  • a). Wernicke Encephalopathy Symptoms are Alexia, Motor activity Disturb, Slurred Speech, Numbness
  • b). Korsakoff syndrome symptoms are Confabulation, Amnesia, Recent and immediate memory loss.
  • 5. Marchia fava Bignami Disease- Neurological Disorder
  • 6. Alcoholic Hallucination – Visual, tactile and auditory hallucination are present.
  • Auditory hallucination is most commonly present in withdrawal of Alcohol.
  • 7. Alcoholic Fits – Occurs due to intake of excessive alcohol.
  • 8. Delirium Tremor – Most common psychological complication. The symptoms seen are Confusion, Disorientation, Tachycardia, Hypertension, Visual Hallucination, and Tremor.

how to prevent alcoholism

Primary Prevention of Alcoholism

  • Identify the substance abusers.
  • Motivational and encourage the all abuser to stop alcohol use
  • Health Educational Provide
  • Improve family condition and socio- economic status
  1. Secondary prevention of Alcoholism

  • Early Detection and Counselling.
  • Motivation interviewing
  • Full assessment done – Medical, psychological and Social problems.
  • Detoxification with Benzodiazepines
  • Psychological therapy provides.
  • Treat the complication of treatment.
  1. Tertiary Prevention of Alcholism

  • Disulfiram or Antabuse provide.
  • Alcoholics anonymous
  • Identify High risk situation and deal with them.
  • Family counselling to reduce interpersonal conflicts
  • Stress management
  • Develop the work habit and capacity
  • Finical management

How to Prevent a Hangover:-

  • Tack A water Bottel:- Sip water or fruit juice to prevent Dehydration and reduce the Quantity of Alcohol.
  • Have a light Snakes:- eat some food like snakes, lemon juice, etc.
  • tack Bed Rest

Related Topic:-

Psychotherapy definition

Electro Convulsive Therapy(ECT)

Key points of Alcoholism:-

  • Physiological and psychological dependence on alcohol is known – Alcohol abuse
  • After alcohol use, feel happy and better is known as – Euphoria
  • Excessive Drinking of Alcohol is known – Dypsomnia
  • Drug of choice of alcohol withdrawal symptom – Benzodiazepines
  • Drug use for aversion therapy in alcohol abuse – Disulfiram
  • Most common psychological complication of alcohol abuse – Delirium Tremor
  • Wernicke Korsakoff syndrome occur due to – Thiamine deficiency and chronic alcohol use.


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