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Explanation of analyzes

Abstinence syndrome: signs and symptoms, treatment, drugs

What it is? An abstinence syndrome is one of the manifestations of a dependence syndrome, in which, in case of refusal to use a certain substance, a complex of symptoms of varying severity develops, leading to psychological and physical discomfort.

The essence of the withdrawal syndrome is that after stopping the regular intake of a substance that has formed a dependence, a person begins to feel bad. This substance is already vital to the body, as it is firmly entwined in the biochemistry of metabolic processes.

If there is no income, i. E. there is abstinence, there is a sobriety syndrome or withdrawal syndrome, which is accompanied by a strong desire to take a "dose of life" again.

Most abstinence develops on alcohol. But a rarity in therapeutic practice is also not, when the dependence is developed for certain drugs. At risk are patients who take narcotic analgesics and psychotropic medications. They actively interfere with the metabolic processes of the brain.


What is the difference between a withdrawal syndrome and a hangover?

abstinence syndrome

The concept of "withdrawal syndrome" is broader, it includes - alcohol withdrawal syndrome (AAS) and narcotic abstinence syndrome, as well as tobacco.

To better understand what it is, let's turn to medical literature. In the reference books on narcology alcoholic withdrawal syndrome is defined as a hangover syndrome or a true hangover. This syndrome is a sign of the disease - chronic alcoholism .

In this case, a hangover means a worsening of the state of health in the absence of alcohol intake and requires rehabbing - re-ingestion of alcohol-containing beverages.

Often, in everyday life there is terminological confusion, and a hangover is called the reaction of a healthy person (not an alcoholic) to the use of a large dose of ethyl alcohol, which causes poisoning or, scientifically, intoxication. In response to poisoning, the body tries to purify itself of "poison" by vomiting. The latter is a compensatory reaction.

After sleep develops "post-toxication syndrome", which manifests itself as headache, nausea, weakness. Strong thirst is typical. In this case, a person is disgusted with alcohol, and in case of his repeated intake, the condition worsens. Therefore, the popular opinion that it is necessary to drink for a hangover is erroneous.

With alcohol withdrawal symptoms appear in the absence of alcohol, since without it, metabolism and normal functioning of the body are disrupted. Alcohol intake, on the contrary, quickly normalizes well-being and physiological parameters.

Thus, with a poor state of health associated with the use of alcoholic beverages, a diagnostic sign is the deterioration or improvement of well-being after their repeated acceptance. This is a distinguishing feature for the diagnosis of "Alcoholism".

An abstinence syndrome with alcoholism occurs some time after stopping the use of ethanol-containing beverages, usually in a few hours. The appearance of symptoms without another alcohol intake, a strong desire to eat and an improvement in the condition when the reception resumes, signals that alcohol consumption is regular and long lasting, as a result, ethanol was "embedded" in the metabolism.

This indicates that a person has a stage 2 chronic alcoholism. Usually, withdrawal syndrome develops after 2 years of stable use of alcohol, with abuse it can occur earlier, after 1 year.

An abstinence syndrome in drug addiction is a so-called "breaking", which occurs when there is no regular dose of a drug substance.

The state of abstinence syndrome develops on average 6-18 hours, and the peak of symptoms is registered 2-3 days after the last episode of drug use.

The most rapidly abstinent syndrome is formed with the use of cocaine and heroin. In the second place - abuse of stimulants and hypnotics. The slowest abstinence occurs with hashishism. Popular spikes in recent years are also characterized by the rapid development of drug dependence.

Signs of withdrawal syndrome

Signs of withdrawal syndrome

In view of the degree of severity, there are 4 types of alcohol withdrawal syndrome (according to F.Iber, 1993). Each subsequent degree indicates a more serious condition of a person, a greater dependence of the body on the intake of ethanol and on the greater difficulties encountered in the treatment process.

  1. Minimal manifestations (mild degree) - are reduced concentration of attention, a feeling of weakness, anxiety, eyes become "running";
  2. Moderate abstinence is expressed by more expressed anxiety, avoidance of direct eye contact in the eyes, the appearance of insomnia, lack of appetite, increased heart rate and respiratory rate, i.e. it can be easily confirmed by objective data to be measured (respiratory rate, heart rate);
  3. Severe abstinence is manifested in a decrease in eye contact to a minimum, the appearance of hallucinations and episodes of a change in consciousness, severe sleep disorders with nightmarish dreams, refusal to eat. There is a frequent pulse, dyspnea;
  4. Severe withdrawal symptoms are manifested by pronounced changes in the psyche in the form of hallucinations, anxiety, fear, aggressiveness, inadequate response. Sleep and appetite is completely disturbed. There is trembling of hands, convulsions, severe sweating, shortness of breath, frequent pulse. There is no eye contact. In this condition, immediate drug treatment is required. If it is late, the likelihood of a lethal outcome increases.

The withdrawal syndrome passes through several phases in its development. Most clearly they manifest themselves in opium abstinence, in which four phases are distinguished.

Первая фаза возникает через 8-12 часов после последнего употребления опия. 1. The first phase occurs 8-12 hours after the last use of opium. It is characterized by the appearance of dissatisfaction and psychoemotional stress.

There is a widening of the pupils, lachrymation, runny nose, yawning, goosebump, disappearance of appetite, disturbance of falling asleep (a person wants to fall asleep, but can not).

Вторая фаза возникает через 30-36 часов. 2. The second phase occurs after 30-36 hours. There is an alternation of feelings of heat and chills, severe weakness, sweating, constant chills, frequent sneezing and yawning, pupils dilated.

There is an unpleasant stiffness and tension in the muscles, which makes it impossible to make a purposeful movement.

Третья фаза наблюдается через 40-48 часов. 3. The third phase is observed after 40-48 hours. A strong craving for drug use is characteristic. The above mentioned signs intensify. In addition, there are drawing pains, reduction of limbs, cramps in the muscles of the back and extremities.

A person constantly changes the position of the body, can not find a place, feels discontent, anger, hopelessness. There are fluctuations in blood pressure, pulse. In this phase, rash acts can be made.

Четвертая фаза наступает через 72 часа. 4. The fourth phase comes in 72 hours. Its distinctive feature - the adherence of digestive system disorders: pain, vomiting and diarrhea, accompanied by painful contractions of the rectum (tenesmus). Attraction to the drug is irresistible.

There is fear, anxiety, there is no sleep, the mood is depressed. All the signs of the first three phases are retained and amplified. There may be short-term outbursts of anger, leading to a dangerous aggressiveness for others.

How long does an abstinence syndrome last?

How long does the withdrawal occur?

The duration of the withdrawal syndrome is the time for which the body tries to get back to normal without using alcohol or a drug. Its duration for alcoholism depends on the stage of the disease, the degree of dependence, and also on how long the last episode of alcohol consumption lasted.

Alcohol abstinence is characterized by the following features:

  • Alcohol abstinence of mild degree lasts for several hours, a person can do without opohmeleniya or it occurs closer to the evening, while the general condition is practically not affected. It is observed at the beginning of the 2 nd stage of chronic alcoholism.
  • With moderate abstinence, changes in health will be observed during the day. As a rule, afterburning is required immediately after sleep to normalize the condition. But with strong will a person can force himself to refrain from drinking alcohol. It is observed in the middle of the 2 nd stage of alcoholism.
  • With severe withdrawal symptoms will persist for several days. It is very difficult to keep from rearing, practically it is not possible. It is observed at the end of the 2 nd stage of alcoholism.
  • Severe withdrawal symptoms accompany the transition of chronic alcoholism to the third stage. It can last up to a week, and when you join the mental disorders characterizing the beginning of the third stage - it can continue indefinitely.

When treating, the duration of withdrawal symptoms lasts from 3 to 10 days. Without treatment, this period is much longer, and in this case the consequences for the body can be very serious.

How to remove withdrawal symptoms?

How to relieve withdrawal symptoms The main principles of treatment of alcohol withdrawal syndrome are to detoxify and soften the manifestations that occur in the absence of alcohol. The duration depends on the patient's initial condition:

3-5 дней проводится внутривенное вливание растворов глюкозы, натрия хлорида (физиологического раствора) в сочетании с витаминами (аскорбиновая кислота, витамины В1, В6), антигистаминными препаратами (хлоропирамин, дифенгидрамин), препаратами, улучшающими мозговое кровообращение (винпоцетин). 1. 3-5 days, intravenous infusion of solutions of glucose, sodium chloride (physiological solution) in combination with vitamins (ascorbic acid, vitamins B1, B6), antihistamine drugs (chloropyramine, diphenhydramine), drugs that improve cerebral circulation (vinpocetine). This reduces the toxic effect of the remaining ethanol in the body.

Прием мочегонных препаратов: фуросемид, верошпирон в таблетках. 2. Taking diuretics: furosemide, veroshpiron in tablets. In combination with a massive infusion, this is called forced diuresis. It helps to remove toxins (acetaldehyde, formed by the metabolism of ethyl alcohol) from the body.

Препараты, снижающие влечение к алкоголю: 3. Drugs that reduce craving for alcohol:

  • To reduce the thrust associated with the depressed state, anticonvulsants are used: carbamazepine;
  • in cases of severe arousal and affects apply neuroleptics: haloperidol, olanzapine, clozapine. They warn the dangerous consequences of hallucinations;
  • to normalize mood and sleep, reduce apathy, anxiety, prevent "rush" to take alcohol prescribed antidepressants: amitriptyline, fluvoxamine.

All listed means are psychotropic. Therefore, in a pharmacy without a prescription they are not sold and do not even need to try to organize self-medication!

Препараты, улучшающие обмен веществ в печени (гепатопротекторы) внутрь: эссенциале, экстракт расторопши. 4. Preparations that improve metabolism in the liver (hepatoprotectors) inside: Essentiale, thistle extract. Essentiale in an acute period can be administered intravenously.

Снотворные, успокоительные препараты: диазепам, зопиклон. 5. Sleeping pills, sedatives: diazepam, zopiclone.

After withdrawal from the acute condition, a course of treatment is recommended that improves metabolism and cerebral circulation. Applied intravenously drip and in tablets: piracetam, alpha-lipoic acid, vitamins C, B1, B6, E, Actovegin, Solcoseryl, Cerebrolysin.

At the same time, drugs that cure alcoholism are used. They cause negative physiological reactions (vomiting, fear of death, palpitations, etc.) when alcohol is consumed, which causes a person to abandon it.

Treatment of withdrawal from drug addiction should always be carried out in the hospital. It consists of several directions:

  • Accelerated detoxification by substances blocking opioid receptors: naloxone;
  • Drugs that affect the central nervous system: neuroleptics, hypnotics, tranquilizers, antidepressants. An effective combination is the reception of clapheline tiapride and tramal;
  • Receiving ibuprofen or another non-steroidal drug to reduce muscle pain in combination with massage and warm baths;
  • Correction of insomnia, anxiety, psychopathy: hemineurin;
  • Substitution therapy with drugs that combine with opium receptors: methadone, buprenorphine;

Complications of withdrawal symptoms

Alcohol abstinence syndrome is a more dangerous condition than abstinence syndrome with drug use. In most cases, "breaking" does not endanger the life of the addict. While alcohol withdrawal can be fatal to conditions.

In this case, such complications as cerebral edema and gastrointestinal bleeding can develop. Also, there may be an exacerbation of chronic diseases, the appearance of nightmares, insomnia, degradation of personality.

Long-term mental disorders lead to the development of delirium, or white fever. At this time a person sees and hears various hallucinations. Often they are frightening, causing suicide.

Alcoholic during the white fever can be heard voices, demanding to kill yourself or others. He can see the hallucinations of people attacking him, which leads to "protection." And all this is so real that it completely replaces "reality".


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