What Role Does Medication Play in Treating Alcohol Use Disorder?

What Is AUD? 

While there once was a 13-year run when America formally prohibited alcohol, today is a much different story. As a product for sale or a beverage on the menu, it is so prevalent today that we have become virtually desensitized to its presence. However, while accessibility is at an all-time high, so are alcohol addiction rates, with numbers up to 14 million adults and counting.

So what exactly is alcohol use disorder (AUD)? At its most basic level, AUD describes a medical condition in which users cannot stop or control alcohol use despite the negative social, occupational, or health consequences. AUD can range from mild to moderate to severe, and some of those consequences might be more central in one category over another. Because of this, noticing patterns early on is challenging to do, but it is also the most important way to identify signs of alcohol abuse. 

Things can quickly go from occasional/recreational drinking to chronic abuse, where dependency withdrawals can occur after only a few hours without alcohol. Some of these signs are much easier to spot, such as drinking in dangerous situations like driving or prioritizing drinking over all other responsibilities. In addition to frequent use, AUD can also be spotted by excessive use. Alcohol overdose can often occur in people with AUD when they have drunk so much that there is too much alcohol in the bloodstream. 

This is known as alcohol poisoning, but it is commonly known as an “overdose,” which helps us link it to some of the familiar dangers we associate with drug overdoses, such as the body’s inability to control heart rate, lung function, and even body temperature. Because of this, AUD can easily become a life-threatening issue. 

Risks and Benefits of Medication

If you or a loved one you know has some of the hallmarks of AUD — even if they have not reached the severe category yet — it might be time to seriously consider treatment for AUD. It might surprise you that, in some cases, medication is used to treat AUD. It might further surprise you that the most common medication used to treat AUD is benzodiazepines (benzos for short). Benzos are among some of the most abused medications in the world, and the U.S. Food and Drug Administration (FDA) labels them with a black box warning, so what gives?

The reason for this is that the withdrawal symptoms during an alcohol detox can be very intense. Delirium tremens (DTs) is a life-threatening withdrawal symptom that is marked by seizures and hallucinations, and a rapid heart rate (tachycardia). Other medications might be used instead of benzos, but not all of them effectively treat seizures. Benzos are the most effective option for seizures, and the ability to choose between fast- and long-acting makes them a dynamic option for the withdrawal process. 

As part of a comprehensive plan, medical professionals might prescribe medication to help diminish some of withdrawal’s more intense symptoms. In-house treatments are preferred because they allow constant monitoring of withdrawal symptoms and a plan to taper dosage over time. Tapering helps ensure that medication dependency does not replace alcohol dependency. 

Still, all medication has its risks, so this is why professional help is preferred over at-home home detox methods or even cold turkey attempts. While the benzo Valium is a popular choice in a controlled detox setting, it can quickly become life-threatening if someone has an alcohol relapse at home and then decides to mix alcohol with benzos, such as Valium. Because both Valium and alcohol are central nervous system (CNS) depressants, mixing them can intensify the depressant effects and result in an overdose, even without drinking too much alcohol or taking too many pills. This scenario is less likely to happen when someone enters a treatment facility for alcohol detox and much more likely when trying to do it on their own.

Taking Action

Much is at stake in a safe and successful detox program. It requires being willing to take the dangers of AUD seriously and the need for a comprehensive plan with friends and family support and medical professionals’ guidance. While it is true that using potentially addictive medication to treat alcohol addiction presents unique challenges, hopefully, this helps make clear that medication selection is unique to each person. Just like the treatment plan, recovery timelines vary by person. This requires a commitment from anyone seeking treatment. But the good news is medical professionals will match that same level of commitment and make every effort to fine-tune a detox program that sets each person up for the best success possible.