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Alcoholism | | Description |
Alcohol Withdrawal
A majority of people who have been
drinking alcohol and decide to stop (often for health-related reasons) are
able to do so without much trouble. Alcohol withdrawal typically becomes
difficult only when problem drinkers-alcoholics-attempt to quit. Almost
inevitably, alcoholics need help in achieving this goal. Sometimes, this
help requires medical intervention in detoxification
centers.
Finding doctors who work with alcohol detoxification is
often as easy as calling the local chapter of Alcoholics Anonymous (AA)
and asking for referral information. Most programs successful in getting
alcoholics to quit drinking are either part of the AA network or employ AA
techniques. Natural approaches to alcohol withdrawal should not substitute
for detox centers or for AA or AA-related programs.
What are the
symptoms of alcohol withdrawal? A person typically has a mild to severe
hangover that lasts several days. Symptoms may include stomach upset;
headache; shakes or jitters; feelings of generalized anxiety or panic
attacks; and insomnia that may be accompanied by bad dreams. There may be
also be increases in heart rate, breathing rate, and body temperature. In
a small proportion of alcoholics, withdrawal may result in severe
symptoms, such as hallucinations, delirium tremens (DTs), or generalized
seizures.
Conventional treatment options: Treatments in
detoxification centers may begin with an injection of vitamin B1 in cases
that involve malnutrition. The conventional treatment is to ensure rest
and adequate nutrition (especially fluid intake and multiple B vitamins,
including thiamine). In cases of severe withdrawal symptoms, a nervous
system depressant, such as a benzodiazepine, is prescribed with a dosage
that is tapered down over three to five days.
Dietary changes that
may be helpful: Some of the nutritional deficiencies associated with
alcoholism can be caused by a poor diet-a factor that needs correction on
an individual basis. Improving the overall diet should be done in
conjunction with a doctor. Sometimes liver or pancreatic disease
associated with alcoholism also contributes to nutritional deficiencies.
These problems require medical assessment and intervention.
In one
trial, a hospital diet was compared with a special diet including fruit
and wheat germ and excluding caffeinated coffee, junk food, dairy
products, and peanut butter. After six months, fewer than 38% of those on
the hospital diet remained sober, compared with over 81% of those eating
the special diet. A review of the research shows that diets loaded with
junk food increase alcohol intake in animals. In a human trial,
restricting sugar, increasing complex carbohydrates, and eliminating
caffeine also led to a reduction in alcohol craving. While the support for
dietary intervention remains somewhat unclear, some doctors suggest that
alcoholics reduce sugar and junk food intake and avoid
caffeine.
Lifestyle changes that may be helpful: Most experts agree
that alcoholics must stop drinking completely in order to overcome the
addiction. Moreover, before nutritional supplements can be used, effective
treatment of the malabsorption problems requires a complete avoidance of
alcohol.
Nutritional supplements that may be helpful: Many
alcoholics are deficient in B vitamins, including vitamin B3. John Cleary,
M.D., observed that some alcoholics spontaneously stopped drinking in
association with taking niacin supplements (niacin is a form of vitamin
B3). Cleary concluded that alcoholism might be a manifestation of niacin
deficiency in some people and recommended that alcoholics consider
supplementation with 500 mg of niacin per day. Without specifying the
amount of niacin used, Cleary's preliminary research findings suggested
that niacin supplementation helped wean some alcoholics away from alcohol.
Activated vitamin B3 used intravenously has also helped alcoholics quit
drinking. Niacinamide-a safer form of the same vitamin-might have similar
actions and has been reported to improve alcohol metabolism in
animals.
Deficiencies of other B-complex vitamins are common with
chronic alcohol use. The situation is exacerbated by the fact that
alcoholics have an increased need for B vitamins. It is possible that
successful treatment of B-complex vitamin deficiencies may actually reduce
alcohol cravings, because animals crave alcohol when fed a
B-complex-deficient diet. Many doctors recommend 100 mg of B-complex
vitamins per day.
Alcoholics may be deficient in a substance called
prostaglandin E1 (PGE1) and in gamma-linolenic acid (GLA), a precursor to
PGE1. In a double-blind study of alcoholics who were in a detoxification
program, supplementation with 4 grams per day of evening primrose oil
(containing 360 mg of GLA) led to greater improvement than did placebo in
some, but not all, parameters of liver function.
The daily
combination of 3 grams of vitamin C, 3 grams of niacin, 600 mg of vitamin
B6, and 600 IU of vitamin E has been used by researchers from the
University of Mississippi Medical Center in an attempt to reduce anxiety
and depression in alcoholics. Although the effect of vitamin
supplementation was no better than placebo in treating alcohol-associated
depression, the vitamins did result in a significant drop in anxiety
within three weeks of use. Because of possible side effects, anyone taking
such high amounts of niacin and vitamin B6 must do so only under the care
of a doctor.
Although the incidence of B-complex deficiencies is
known to be high in alcoholics, the incidence of other vitamin
deficiencies remains less clear. Nonetheless, deficiencies of vitamin A,
vitamin D, vitamin E, and vitamin C are seen in many alcoholics. While
some reports have suggested it may be safer for alcoholics to supplement
with beta-carotene instead of vitamin A, potential problems accompany the
use of either vitamin A or beta-carotene in correcting the deficiency
induced by alcoholism. These problems result in part because the
combinations of alcohol and vitamin A or alcohol and beta-carotene appear
to increase potential damage to the liver. Thus, vitamin A-depleted
alcoholics require a doctor's intervention, including supplementation with
vitamin A and beta-carotene accompanied by assessment of liver function.
Supplementing with vitamin C, on the other hand, appears to help the body
rid itself of alcohol. Some doctors recommend 1 to 3 grams per day of
vitamin C.
Kenneth Blum and researchers at the University of Texas
have examined neurotransmitter deficiencies in alcoholics.
Neurotransmitters are the chemicals the body makes to allow nerve cells to
pass messages (of pain, touch, thought, etc.) from cell to cell. Amino
acids are the precursors of these neurotransmitters. In double-blind
research, a group of alcoholics were treated with 1.5 grams of
D,L-phenylalanine (DLPA), 900 mg of L-tyrosine, 300 mg of L-glutamine, and
400 mg of L-tryptophan (now available only by prescription) per day, plus
a multivitamin-mineral supplement. This nutritional supplement regimen led
to a significant reduction in withdrawal symptoms and decreased stress in
alcoholics compared to the effects of placebo.
The amino acid,
L-glutamine, has also been used as an isolated supplement. Animal research
has shown that glutamine supplementation reduces alcohol intake, a finding
that has been confirmed in double-blind human research. In that trial, 1
gram of glutamine per day given in divided portions with meals decreased
both the desire to drink and anxiety levels.
Alcoholics are
sometimes deficient in magnesium, and some researchers believe that
symptoms of withdrawal may result in part from this deficiency.
Nonetheless, a double-blind trial reported that magnesium injections did
not reduce symptoms of alcohol withdrawal.
Because of the multiple
nutrient deficiencies associated with alcoholism, most alcoholics who quit
drinking should supplement with a high-potency multivitamin-mineral for at
least several months after the detoxification period. Whether or not the
supplement should include iron should be discussed with a
doctor.
Are there any side effects or interactions? Refer to the
individual supplement for information about any side effects or
interactions.
Herbs that may be helpful: Milk thistle extract is
commonly recommended to counteract the harmful effects of alcohol on the
liver. Milk thistle extracts have been shown in one double-blind study to
reduce death due to alcohol-induced cirrhosis of the liver, though another
double-blind study did not confirm this finding. Milk thistle extract may
protect the cells of the liver by both blocking the entrance of harmful
toxins and helping remove these toxins from the liver cells. Milk thistle
has also been reported to regenerate injured liver cells.
Kudzu is
most famous as a quick-growing weed in the southern United States.
Alcoholic hamsters (one of the few animals to become so besides humans)
were found to have decreased interest in drinking when fed kudzu extract.
Traditional Chinese medicine practitioners generally recommend 3 to 5
grams of root three times per day; some herbal practitioners also suggest
that 3 to 4 ml of tincture taken three times per day may also be helpful
to reduce alcohol cravings. Nonetheless, a double-blind trial using 1.2
grams of powdered kudzu root twice per day failed to show any benefit in
helping alcoholics remain abstinent from alcohol.
Are there any
side effects or interactions? Refer to the individual herb for information
about any side effects or interactions.
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