Withdrawal

• A physician working in medical treatment of alcoholism first focuses on assessing the client's physical condition and keeping her stabilized through any withdrawal symptoms. Patients with serious physical alcohol dependence may develop delirium and seizures, and the doctor will prescribe medication to prevent this. Withdrawal seizures are more likely in individuals with a history of previous detoxification episodes.
  
  

Medications for Withdrawal

• Physicians might prescribe a barbiturate or a benzodiazepine, sedative drugs which are in the same classification as alcohol and can reduce withdrawal symptoms. Long-acting benzodiazepines are most frequently prescribed, and include diazepam (Valium), lorazepam (Atvian) and chlordiazepoxide (Librium). Medications can be administered by injection or intravenously along with hydrating fluids, or the patient can take them orally. Dosages are gradually reduced over several days until any danger of seizure has passed.
  
  

Ketoacidosis

• Alcoholic ketoacidosis occurs when excessive alcohol consumption causes ketones to build up in the blood, raising blood acidity. This condition is treated with intravenous hydration fluids and electrolyte replacement, and glucose if necessary, until the client can start drinking fluids and eating again.
  
  

Vitamins

• Additionally, the alcoholic may have deficient levels of thiamine, or vitamin B1, because alcohol interferes with thiamine absorption. The doctor may administer a thiamine injection to prevent Wernicke's encephalopathy and Korsakoff syndrome, a spectrum of disorders that cause abnormal eye movements and severe memory impairment. Physicians also might provide a folic acid supplement, because alcohol interferes with folate absorption, resulting in anemia.
  
  

Preventing Relapse

• After withdrawal and detoxification, the person begins the difficult journey to abstinence. A drug called disulfiram (Antabuse), which has traditionally been used to keep people from drinking, is not as commonly prescribed as it once was. Disulfiram causes the alcoholic to experience nausea and even vomiting if he drinks alcohol while taking the drug. This deters people from drinking while taking disulfiram, but it also tends to deter people from taking the disulfiram. Other prescription medications have been shown to be more effective at preventing relapse, primarily naltrexone (ReVia) and acamprosate (Campral), which reduce the craving for alcohol.