Abstinence syndrome

Description:

Abstinence syndrome (Latin abstinentia — abstention) — the syndrome of physical and/or mental disorders developing at patients with drug addiction and alcoholism after a while after the termination of reception of drug, alcohol or reduction of their dose. The abstinence syndrome is a component of a syndrome of physical dependence.

The abstinence syndrome can be subdivided on an etiology into an alcoholic abstinence syndrome (in the people it is better known as a hungover syndrome or a hangover) and a narcotic abstinence syndrome (in the people it is also known as "withdrawal pains").

Time of development of an abstinence syndrome after the termination of a narcotization for various forms of drug addiction variously: most quickly there are abstinence signs when smoking — within an hour; alcoholism — several hours later, most slowly at an opiomania — 20 — 24 hours.

The abstinence syndrome in clinic of a disease forms gradually, at various forms of drug addiction in various terms: the most slowly abstinence syndrome forms at a hasheeshism, quicker — at alcoholism, even quicker — at abuse of hypnotic drugs and stimulators, most quickly — at an opiomania and a cocainism. At the use of some substances classified as narcotic the abstinence syndrome does not form in general (acid) or its manifestations are insignificant (abuse of flying narcotic active ingredients). Existence of these or those symptoms in structure of an abstinence syndrome is defined by a specific form of drug addiction (for example, see a hungover syndrome — a special case of an abstinence syndrome at alcoholism). After overcoming an acute abstinent state the main principle of creation of the narcological therapeutic program is suppression of residual psychopathological symptomatology. Neuroleptics, antidepressants, mood stabilizers, blockers of opiate receptors are for this purpose used.

Symptoms of the Abstinence syndrome:

The abstinence syndrome at all forms of drug addiction is presented by two main groups of symptoms: symptoms psychopathological and symptoms vegetative, somatoneurologic. Expressiveness of these groups of symptoms different for various forms of drug addiction, for example, at a barbituromaniye is expressed psychopathological symptomatology, on an opiomania and a hasheeshism — vegetative. Expressiveness of symptomatology of an abstinence syndrome at one form of drug addiction is proportional to intensity of the previous narcotization.
The abstinence syndrome has a phase current (that is specific phases and symptoms making them are various for different forms of drug addiction), at recession of abstinence the return sequence of disappearance of symptoms is characteristic: earlier those symptoms which at development of abstinence appeared later disappear.
Pathogenetic abstinence syndrome — attempt of an organism own resources for lack of drug to reproduce the conditions corresponding narcotic intoxication, that is a condition necessary for satisfactory functioning of an organism. The pathological symptomatology of an abstinence syndrome is a consequence of imperfect compensation in the conditions of lack of drug. The abstinence syndrome is a cardinal sign alcoholism. If someone has it, then to refuse the diagnosis "alcoholism" as it is done by some patients, it is already impossible. The internal reason of an indisposition both at a usual hangover, and at an abstinence syndrome is accumulation of toxic  substances, alcohol decomposition products which in the alcoholic's organism unlike the ordinary person, first, more, secondly, it is followed by the broken work of internals – a liver, a pancreas, a brain, vessels, heart.

The alcoholic abstinence syndrome differs from a banal hangover in the duration. Usually it keeps several days, and then gradually disappears, but more than 3-5 days none of patients maintain and usually gets drunk again, and continuation of alcohol intake till some time softens or reduces displays of an abstinence syndrome. Other reason why the abstinence syndrome does not last more specified days such is that the organism is recovered and eliminates all hungover complaints. At last, the third reason – an abstinence syndrome comes to the end with psychosis which in the people and old psychiatrists call delirium tremens.

The alcoholic abstinence syndrome differs from a simple hangover in the force and quality. The usual indisposition is replaced by enormous weakness here. Not only hands, but also all body shiver. Vomiting in mild cases usually does not happen, but in heavy – vomiting not only unrestrained, or only to gastric contents, but also with obsessed a 12-perstny gut (bile) and it is frequent with blood. Blood traces in emetic masses is a terrible sign after what massive gastric bleeding, literally, can begin a stream. And then only the emergency surgical intervention will be able to save the patient. Blood comes to emetic masses from burst become thinner and varicose expanded veins of a gullet and a stomach. In turn so-called varicosity happens because of the begun or proceeding cirrhosis. Very often there is an exacerbation of the hemorrhoids which are also representing option of the expanded and bursting varicose vessels of a rectum overflowed with a venous blood. Sometimes bleeding happens intra intestinal, and then its symptom is coaly the kcal. In this case relatives also should not hesitate, and urgently to call the ambulance, otherwise the patient can die.

Very seldom alcoholics have a headache at an abstinence syndrome. But if it appeared, then the reason can be in the old injuries which are followed by increase in intracranial pressure or pressure of hems, and also an exacerbation of a hypertension.

Persistent sleeplessness with the advent of dreadful dreams is characteristic of an alcoholic abstinence syndrome, and also if the state lasts up to five days – emergence of deception of perception – visual or acoustical. In knock of the wall clock or in knock of wheels of the train threats in the address are heard, and the coat hanging in a hall being accepted to the hidden person. If these phenomena proceed further, then they come to the end with development of already mentioned delirium tremens or a tremens when hallucinatory images (first of all visual) fill all consciousness of the person, forcing out natural information from sight or hearing.

The alcoholic abstinence syndrome is dangerous not only the fact that it can be followed by various internal bleedings or development of delirium tremens, but also defeat of all other bodies in the form of an exacerbation of already existing diseases or emergence of new. So, for example, very often at such patients acute or chronic pancreatitis which main symptom a back pain and in left hypochondrium develops. In the presence of these symptoms it is also required to call urgently the ambulance or to address the surgeon. Pains in right hypochondrium demonstrate damage of a liver – alcoholic hepatitis or even cirrhosis.

Reasons of the Abstinence syndrome:

The reasons of an abstinence syndrome at alcoholism that the organism does not manage to process a large amount of alcohol, and at dependent, besides, are already problems with work of the liver which is responsible for these processes.  As a result in an organism the toxic substances provoking emergence of unpleasant feelings collect.

The alcoholic abstinence syndrome usually begins in 7-10 hours after the termination of alcohol intake and lasts from several hours to several days. Reception of alcoholic drinks stops abstinent frustration (stopping of alcoholic abstinence). At initial stages of the development the alcoholic abstinence syndrome is shown only after high doses of alcoholic drinks, further — irrespective of amount of the accepted alcohol.

Treatment of the Abstinence syndrome:

It is much more difficult to help the person with a condition of an abstinence syndrome, than at usual alcoholic poisoning, first of all, because the alcoholic of people, as a rule, inadequately perceives the state. It is necessary to understand well that if the patient had the real abstinence syndrome, then it is in a condition of hard drinking and needs immediate medical care. Help in certain cases can be given at home, but consultation of the doctor nevertheless is obligatory, and in heavier the patient is placed in the conditions of the prepared hospital.
By the way, narcologists consider that full anesthesia of an abstinence syndrome negatively influences further recovery of the alcoholic since protective mechanisms of a disease leave only pleasant memories in memory of the patient soon, than cause still big problems in treatment and rehabilitation of the alcoholic. Therefore the first stage of treatment of an abstinence syndrome is its stopping for the prevention of further development of hard drinking. To the patient the drugs supporting cordial activity and tranquilizers (the drugs of psychotropic action replacing temporarily alcohol) with the subsequent their gradual cancellation are appointed. Also the symptomatic treatment, directionally on fight against neurosis, an adynamy, a sleep disorder is carried out.