What is withdrawal alcohol syndrome, you should clearly understand that, if necessary, quickly help to cope with this condition yourself or help a loved one who is dear to you. In fact, this is a complex of symptoms of a pathological nature that appear in chronic drinkers when they refuse to drink alcohol regularly. Alcohol-withdrawal syndrome (ICD-10 code will be presented below) is considered an official mental illness. Outwardly, it may resemble a hangover, but differs from it in some additional signs, as well as in duration. As a rule, withdrawal syndrome of alcohol dependence develops only in patients suffering from the second or third stage of alcoholism. If there is no addiction, then it does not appear at all. Typical manifestations are palpitations, sweating, impaired movement, shaking hands, mood swings, and sleep disturbance. In some cases, it can become delirium tremens. It is treated exclusively with infusion therapy.
Status Features
In this article, we will describe in detail what withdrawal alcohol syndrome is, how to identify it and how to deal with it. In everyday life, this condition is also called withdrawal syndrome. When it occurs, there is a whole range of all kinds of neurological, psychological, autonomic and somatic disorders that occur after a long and systematic use of alcohol.
What is withdrawal alcohol syndrome, can only find out people with a similar addiction. Its first manifestations are observed in the second stage of alcoholism. Some of them are completely identical to the usual hangover, however, individual symptoms are typical only for this condition. For example, an irresistible craving for alcohol. How long does alcohol withdrawal syndrome last? If the hangover goes away within a few hours, then this condition lasts several days.
This pathological condition is considered a mental disorder, therefore it is classified by WHO and has its own code for ICD-10. Alcohol withdrawal syndrome does not develop immediately.
The time period from the onset of alcohol abuse to the formation of this condition is from two to fifteen years. At the same time, specialists have long noted the relationship between age, gender and the time of the onset of this condition. For example, in adolescents and youths, the first signs of withdrawal symptoms appear a maximum of three years after regular drinking, and after five years of alcohol abuse, the disease becomes pronounced.
In women, the syndrome appears about three years after regular intake of alcohol.
Place in the International Classification of Diseases
This condition occupies a special place in the International Classification of Diseases. In ICD-10, alcohol withdrawal syndrome belongs to the fifth class. It is called Mental and Behavioral Disorders.
In this section of the ICD, alcohol withdrawal syndrome is found along with other mental disorders. This is how specialists characterize this problem.
In ICD-10, alcohol withdrawal syndrome is listed under F10. Its scientific name is mental and behavioral disorders caused by the use of alcohol. The specific code for alcohol withdrawal syndrome according to ICD-10 is F10.3. This includes a list of symptoms of every possible type and severity that occur after the partial or complete elimination of the psychoactive substance from the patient’s body, which before then was constantly ingested. The duration of this condition directly depends on the dose of alcohol that was taken immediately before the decrease or cessation of alcohol consumption. This condition can be complicated by convulsions.
Origin
To understand what withdrawal alcohol syndrome is, the pathogenesis of this condition will help. We will tell you more about it. When the next dose of ethanol enters the body, it begins to break down in several ways. In all cells of the body, this occurs with the participation of the enzyme catalase, and in the cells of the liver with the participation of the enzyme alcohol dehydrogenase and the microsomal ethanol-oxidizing system.
In this case, acetaldehyde becomes an intermediate product of metabolism. This situation is observed in all cases without exception. Acetaldehyde is a highly toxic compound that has a negative effect on the work of the whole body, causing a state of hangover.
If a person is healthy, he has no dependence, alcohol dehydrogenase is mainly involved in the breakdown of alcohol. But if you drink alcohol systematically, alternative options are activated, because of which the amount of acetaldehyde in organs, blood and tissue will increase markedly. This substance affects the breakdown and synthesis of dopamine.
With prolonged use of alcohol for a long time, dopamine reserves are depleted. At the same time, alcohol itself combines with nerve cell receptors, filling up the deficit that forms in them. In the first stage of alcoholism, a person suffers from insufficient stimulation of receptors. It is caused by a lack of dopamine, which is replaced by alcohol. As a result, mental dependence begins to form. These are all signs of a mental disorder. That is why this condition is, according to the International Classification of Diseases, among mental illnesses and behavioral disorders.
In the second stage of alcoholism, events develop in a completely different way. As a result of the temporary cessation of alcohol intake, a breakdown of compensation occurs, due to which the body begins not only the breakdown, but also the synthesis of dopamine. Its level is growing, which leads to the emergence of vegetative reactions, which are the main signs of this condition.
It is because of the change in the level of dopamine that anxiety and irritability appear, sleep is disturbed, blood pressure rises. The severity of withdrawal symptoms directly depends on what is the indicator of dopamine in the blood. For example, if its content is three times higher than the norm, delirium tremens begins, which is scientifically called alcoholic delirium. This is due to the fact that acetaldehyde delivers significantly less oxygen to the tissues, due to which metabolism is disrupted, and oxygen starvation begins in cells of various organs. Due to tissue hypoxia, somatic symptoms occur.
The depth of damage to the body by alcohol and its excretory products in patients with withdrawal symptoms affects the duration of this condition. Withdrawal can last up to five days. Moreover, on the third day there is a peak in the manifestation of symptoms, then they gradually begin to recede.
Severe cases are known when the state of withdrawal persisted for two to three weeks. This is the clinic of alcohol withdrawal syndrome.
Classification
Depending on the severity of withdrawal symptoms, several degrees are distinguished. Also, this is influenced by the predominance of one or another symptomatology, the occurrence of certain symptoms. Three degrees of withdrawal can be distinguished when the patient has a second stage of alcoholism.
The first degree appears during the transition from the first stage of alcoholism to the second. It occurs with short binges, when alcohol is consumed no more than two to three days in a row. You can recognize it by violations of the autonomic nervous system and asthenic symptoms. At this stage of the mental disorder, the classic symptoms of alcohol withdrawal symptoms are dry mouth, palpitations, excessive sweating.
The second degree develops in the middle of the second stage of alcoholism. It occurs when binges last from three to ten days. In addition to autonomic disorders, there are symptoms associated with internal organs, neurological disorders. This stage can be distinguished by redness of the proteins of the eyes and skin, fluctuations in blood pressure, palpitations, vomiting, nausea, heaviness in the head and nausea, trembling hands, impaired gait.
The third degree manifests itself when the second stage of alcoholism gradually begins to pass into the third. It appears only with binges lasting more than ten days. Somatic and autonomic symptoms go by the wayside. The clinical picture is mainly characterized by mental disorders. Symptoms of alcohol withdrawal syndrome at this stage are nightmares, sleep disturbance, dreary mood, guilt, aggression and irritation towards others.
When a patient develops a third stage of alcohol dependence, all of the above symptoms become pronounced. It should be understood that the symptoms of withdrawal symptoms with alcohol dependence can vary, and their severity depends on the duration of a particular binge, the general condition of the human body. The main difference between abstinence and a hangover is the irresistible craving for alcohol in the first case, which begins to increase in the evening.
Symptoms
Two groups of manifestations of alcohol withdrawal syndrome are distinguished depending on the time of occurrence. The first symptoms appear after a period of six hours to two days after refusing alcohol. If the patient starts drinking again, the symptoms may soften or completely recede.
After a complete rejection of alcohol, the patient's irritability increases, he becomes restless and irritable. Characteristic signs of alcohol withdrawal symptoms during this period are hand shake, palpitations, excessive sweating, high blood pressure, diarrhea, aversion to food, vomiting and nausea. At the same time, muscle tone is reduced, there may be impaired attention, memory and judgment.
Two to four days after giving up alcohol, later symptoms appear. They already relate mainly to the field of the mental sphere. Serious disorders can occur against the background of exacerbation of certain symptoms that were in the early stages. For example, agitation, palpitations, trembling hands, or sweating. During this period, the patient's condition can change dramatically. Hallucinations, epileptic seizures, confusion, delirium may occur. Delirium appears on the basis of strong hallucinations, as a rule, has a paranoid character. Usually the patient feels that someone is chasing him.
The pattern according to which early symptoms precede late ones is not always observed. In some cases, late symptoms may be absent altogether or may appear suddenly against the background of a normal general condition, when withdrawal is weak or not at all. It is noteworthy that some of the later symptoms can also be reduced, turning into alcoholic delirium. With the onset and progression of signs of late symptoms, delirium tremens eventually develops.
First aid
In some cases, a person is required to provide emergency care for alcohol withdrawal syndrome. If the patient's condition causes serious concern, it is necessary to call an ambulance team. Doctors have a clear algorithm of actions that they must follow when faced with this mental disorder. They are well aware of what to do with alcohol withdrawal symptoms.
The first step is to ensure ventilation and airway. If there is mucus in the oral cavity, it is removed. If the patient has hypopharyngeal obstruction, an air duct is inserted, and a protective collar is hung on the neck. A patient in a coma is transferred to mechanical ventilation. While maintaining inadequate ventilation, tracheal intubation is possible.
Then, doctors in first aid for alcohol withdrawal symptoms measure blood pressure and measure the pulse. The state of consciousness should be established on the UNV scale (arousal, response to voice, response to pain impulses, no response to voice and pain) and Glasgow scale. The size of the pupils and their response to light are evaluated, and examination is carried out in the main anatomical areas.
Next, you need to provide access to the vein to place a catheter. Blood is taken for a forensic chemical study, 400 ml of a 5% glucose solution is prescribed, 50 mg of thiamine is administered intravenously.
In case of arterial hypertension, “Nifedipine” should be given, in the absence of effect, “Diazepam". The last drug is prescribed for seizures. If the patient vomits, he is placed on his side. In this case, pay attention to the smell and color of the vomit.
After the ECG is recorded, the heart rate is especially important. Repeated examination of the anatomical areas. Body temperature is measured, on the call card, doctors note the clinical manifestations of withdrawal symptoms and their treatment. In this case, it is necessary to register the degree of depression of consciousness, symptoms detected during examination of the head, mental disorders, pulse rate, blood pressure, body temperature, the smell emanating from the patient, clinical manifestations of diseases of the thyroid gland, abdominal cavity, and other somatic pathologies.
In conclusion, the main diagnosis is formulated, and complications, if any, are listed.
If it is necessary to transport the patient to the hospital, it is necessary to control blood pressure, respiratory rate and pulse throughout the entire journey.
Treatment
The treatment of this mental disorder is carried out by narcologists. If the patient has a mild form of withdrawal disorder, help can be provided at home without hospitalization. In this case, an intravenous infusion of saline solutions, detoxification and vitamin therapy are carried out. It is necessary to ingest funds that improve the functioning of the nervous system and restore internal organs.
Benzodiazepines are prescribed to patients. These are drugs that act as a sedative to deal with anxiety. They also affect the autonomic system, eliminating possible violations.
Hospitalization should be carried out in case of exhaustion of the patient or with the appearance of severe hyperthermia, significant dehydration, severely trembling limbs, tongue, eyelids, with epileptic seizures, hallucinations, and a state of impaired consciousness.
Inpatient treatment for somatic pathology is also required. For example, with respiratory failure, gastrointestinal bleeding, pancreatitis, liver failure, pneumonia, acute bronchitis. Hospitalization is also mandatory for such mental disorders as manic-depressive psychosis, schizophrenia, and alcohol depression.
In the conditions of inpatient treatment, the patient receives medical assistance. The scheme, which is used in outpatient treatment, is supplemented with anticonvulsants, antipsychotics, tranquilizers, sleeping pills, drugs for the correction of somatic and mental disorders, nootropics. Patients should adhere to a special diet, attend plasmapheresis.
Throughout the treatment, the patient is under the close supervision of a narcologist.
Home methods
Is it possible to treat alcohol withdrawal symptoms at home? Effective methods will be at the very beginning of binge, and in the later stages only qualified specialists can help.
To relieve withdrawal symptoms, the patient should avoid additional stress on the heart, have a lot of rest, while minimizing activity. At home, a good way to tone the body is a contrast shower. A few days after giving up alcohol, you can gradually switch to moderate physical activity. A visit to the bathhouse, sparing sports activities, will help relieve intoxication.
At the beginning of drinking bouts, it is effective to take such drugs as Proproten-100, Zorex, Alka-Seltzer.They relieve hangover. With vomiting, Metoclopramide or Cerucal will help. It is worth noting that it is better to take any medications after consulting with your doctor in advance.
Serious problems with the gastrointestinal tract often occur during binge. It is very difficult to understand the symptoms of diseases on your own, therefore, when the first signs of discomfort appear, you should seek the help of a doctor so as not to aggravate the condition.
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Prevention
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During this time, the body will have time to fully recover, especially the myelin fibers of the nervous system. With repeated libation, the primary damage to organs and systems of the body can only worsen, contributing to the development of withdrawal symptoms. In this case, he will indicate a clear formation of strong alcohol dependence.
Forecast
The prognosis for this pathological condition may be different. In mild cases, all symptoms can disappear within ten days. If treated on an outpatient basis or at home under the supervision of a narcologist, withdrawal symptoms will disappear in five days.
In severe withdrawal, it all depends on a large number of factors - the severity of mental disorders, the form of the disorder, the severity of somatic pathology. The most severe form of the disease develops when the symptoms associated with psychopathological disorders prevail in the clinical picture, as well as during the transition to delirium. Visceral and neurovegetative options have a shorter duration and are much easier.
Recall that the visceral version of the clinical picture is formed using pathological symptoms. The main role in this is played by internal organs. The classic manifestations in this case are bloating, scleral jaundice, nausea, diarrhea, vomiting, arrhythmia, shortness of breath, pain in the heart and epigastric region.
The neurovegetative option is considered one of the most common. It is manifested by general weakness of the body, sleep disturbances, palpitations, lack of appetite, trembling hands, high blood pressure, dry mouth and excessive sweating of the patient. These conditions are not considered as serious and dangerous as extreme forms of withdrawal, but they still pose a danger to humans.
In conclusion, it is worth noting that this type of mental disorder is considered a sign of an already developed alcohol dependence. If after such serious health problems the patient continues to take alcohol, over time the condition will only worsen, and alcoholism will begin to progress. Therefore, with the manifestation of the first symptoms of withdrawal symptoms, you must definitely seek help from a narcologist.