Withdrawal syndrome (Withdrawal syndrome, Abstinence)

Alcohol withdrawal syndrome
can be relieved at home
, but this is not easy to do, and the process itself is slow and painful. This should be understood if you really intend to quit the binge and overcome the withdrawal state without the help of a narcologist. We will give as much useful advice as possible on the treatment of withdrawal symptoms due to drug and alcohol addiction, but we strongly recommend that you do not delay your visit to specialists.

IMPORTANT!

KNOW ABOUT WITHDRAWAL SYNDROME

NARCOLOGY IN MOSCOW

Narcologists should help you stop drinking. We give this advice not because we devalue the care of your loved ones or really effective advice, but for the reason that a person simply cannot know what state his body is in, and how the organs and systems of the body are currently functioning. This can only be shown by tests and clinical observations, and this can only be done in a hospital setting, where there is appropriate equipment, and specialists can quickly and individually change approaches to treatment.

Of course, there are emergency methods for relieving withdrawal symptoms, in particular, we can talk about placing an IV, but unpleasant sensations (fever, chills, aching bones, headache, nausea, tremors and others) remain. You can prescribe symptomatic treatment and pain relief, but going through withdrawal at home is very, very difficult. It is not surprising that 99.9% of patients prefer to resort to the old proven measure: drink another glass of alcohol.

Relieving alcohol intoxication

To relieve mild alcohol intoxication, gastric lavage is done, 0.01 phenamine, 0.2 corazole are prescribed orally, 20 ml of a 40% glucose solution with 2 ml of a 5% vitamin B solution is injected intravenously, and if necessary, 2 ml of cordiamine is injected subcutaneously. You can inject subcutaneously 0.3-0.5 1% apomorphine solution, 2 ml of cordiamine and 1-2 ml of 10% caffeine solution.

For severe intoxication, special analeptic mixtures are used: corazol - 0.2, phenamine - 0.01, nicotinic acid - 0.1 or bemegride - 0.5% 15 ml, etimizol - 1.5% 1 ml, cordiamine - 2 ml, caffeine - 20% 2 ml, corazol - 10% 2 ml, glucose - 40% 20 ml, isotonic sodium chloride solution - 400 ml.

In case of coma, the technique of forced diuresis is used, water and electrolyte metabolism is corrected, and the acid-base state of the blood and hemodynamic parameters are carefully monitored. Polyionic mixtures, hemodez, mannitol, furosemide, 4% sodium bicarbonate solution, cardiovascular drugs, prednisolone or hydrocortisone are widely used.

Breathing disorders of the central type are an indication for transferring patients to machine (controlled) breathing.

It is not recommended to prescribe antipsychotics to relieve agitation. In superficial and deep coma, restoration of pulmonary ventilation is achieved using an airway or intubation, the contents of the upper respiratory tract are aspirated. To reduce bronchorrhea and hypersalivation, 12 ml of a 0.1% atropine solution is administered. Polyglucin and hemodez (400 ml) are used. 10,000-20,000 units are administered. heparin, 60-120 mg of prednisolone or 125-250 mg of hydrocortisone, 600-1000 ml of 4% sodium bicarbonate solution, 500 ml of 20% glucose solution and 20 units. insulin, 400 ml of isotonic sodium chloride solution, vitamin B, 5% 35 ml, 35 ml of 1% nicotinic acid, 510 ml of 5% vitamin C solution.

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Relief of binge drinking and alcohol withdrawal syndrome

The main goals are to stop alcohol consumption, normalize sleep, prevent the occurrence of seizures and psychoses, and suppress the desire for alcohol.

In an outpatient setting, when stopping mild binges and there are no somatic contraindications, pyrotherapy can be used. 1 ml is injected intramuscularly. 1% or 0.33% sulfozine solution or subcutaneously 750-1500 IU of pyrogenal. At the same time, sleeping pills are prescribed at night. An increase in temperature to 38°-39° C leads to a decrease in craving for alcohol. Hyperpyretics are administered 2-3 times over the course of a week. This way it is possible to stop approximately 90% of binge drinking. This method is contraindicated for stopping severe binges, accompanied by a complete lack of appetite, a decrease in tolerance to alcohol and an increase in neurological symptoms.

To normalize sleep and mood, sleeping pills and tranquilizers are used. The oldest and most effective method is to prescribe phenobarbital (0.4) or sodium amytal (0.5) along with a small dose of alcohol (40-50 ml of ethyl alcohol diluted in 60 ml of water). This mixture (Popov’s mixture) within 10-15 minutes leads to the disappearance of somato-vegetative disorders for some time, a decrease in anxiety, and often to the onset of sleep. Alcohol with barbiturates is usually prescribed 2 times a day, once at night.

Parenteral administration of 20-40 mg of diazepam (Seduxen), which reduces anxiety and promotes sleep, is very effective. Phenazepam (1-2 mg) in combination with phenibut (up to 1750 mg/day) not only eliminates anxiety, but also helps restore the normal ratio of slow-wave sleep and paradoxical sleep.

The effect of any hypnotics is enhanced by diphenhydramine and pipolphen. Other drugs used include clomethiazole (geminevrin) in the form of capsules of 0.3 or a slowly administered 0.8% solution intravenously, zopiclone (imovan) 7.5-15 mg, zolpidem (ivadal) 10-20 mg, midazolam (dormicum ) 5 mg intramuscularly, nitrazepam (Eunoctin) 5-20 mg orally, reladorm (cyclobarbital with diazepam) 1-2 tablets at night, flunitrazepam (Rohypnol) intramuscularly 2-4 mg or 1-2 mg orally for maintenance long sleep.

To eliminate anxiety, apiprozalam is prescribed at 0.25-0.5 mg 3 times a day, lorazepam at 1.25-5 mg 2-3 times a day orally. Phosphabenzide (F-189) eliminates anxiety and reduces craving for alcohol, prescribed 0.5 3 times a day orally.

To quickly induce sleep, sodium hydroxybutyrate is used, which is administered intravenously in the form of a 20% solution of 10-20 ml or given in the form of a 5% syrup of 50-60 ml. Most often they resort to a combination of drugs. Thus, the simultaneous administration of diazepam (20-40 mg) and haloperidol (10-15 mg) is common. Sema et al (1985) proposed simultaneous administration of Popov's mixture, sodium hydroxybutyrate, diazepam, and haloperidol. To eliminate excessive sympathicotonia, it was proposed to prescribe 100 mg of pyrroxan per day or 0.075 mg of clonidine several times a day.

Mianserin (Lerivon) is given orally at a dose of 30-60 mg per day to relieve withdrawal symptoms. Positive results were obtained with the use of Coaxil (37.5 mg per day) and the homeopathic drug Proproten. Therapy can be supplemented by prescribing finlepsin 0.2-0.3 2-3 times a day; the drug is especially indicated in the treatment of patients with residual effects of organic brain damage, as well as in the event of convulsive paroxysms.

According to the effect that relieves withdrawal symptoms, the most commonly used drugs are ranked as follows: lerivon, mexidol, proprotene, phenazepam, seduxen, haloperidol.

Additionally, antispasmodics are prescribed: papaverine 20 mg 2-3 times a day, aminophylline 5-10 ml of a 24% solution intravenously. If necessary, to maintain cardiac activity, corglucon is administered - 0.06% 1 ml slowly intravenously or 0.05% strophanthin solution 0.5 ml on glucose (slow intravenous).

If collapse occurs, 120 mg of prednisolone is immediately administered intramuscularly. The use of alkaline solutions (Borjomi) is useful. For these purposes, drinking soda is prescribed up to 6 g per day. Vitamin therapy is mandatory: vitamin B1 (thiamine) 2-3 ml of a 6% solution intramuscularly, vitamin B6 (pyridoxine) 1 ml of a 5% solution intramuscularly (cannot be mixed in the same syringe with vitamin B and vitamin B)2), vitamin C (ascorbic acid) 0.2 three times a day, vitamin PP (nicotinic acid) 0.05-6.1 3 times a day. In addition, other vitamins are administered in the form of tablets (multivitamin preparations: as-nitin, pentovit, heptavit, glutamevid).

You can stop binge drinking and hangover in any therapeutic hospital, but it is better to do this in a specialized drug treatment or psychiatric department.

The most severe binges, accompanied by refusal to eat, repeated vomiting, and increasing neurological disorders, should be stopped in a hospital setting. Treatment involves normalizing homeostasis with control over water-electrolyte metabolism and acid-base status. Infusion therapy is carried out with the obligatory use of small dosages of alcohol (up to 100 ml of 40° alcohol 1-2 times a day). Polyionic mixtures, polyglucin, hemodez (400 ml), antioxidants, and nootropics are introduced. Intramuscular administration of a 5% solution of Mexidol (100-200 mg), piracetam (up to 6-8 g per day) is very effective. Additionally, biotretin is prescribed 900 mg per day, limontar 3-5 tablets per day, sodium nucleinate 0.5 g 2-3 times a day, glycine 0.1 g 3 times a day, glutamic acid 1.0 g 2-3 times a day, methionine 0.5-1.5 g 3-4 times a day, 10-3D ml of 25% solution of magnesium sulfate is administered intramuscularly.

Non-drug methods include plasmapheresis, hemosorption, enterosorption (oral administration of activated carbon), and craniocerebral hypothermia. According to some narcologists, with exposure to cryotherapy for 1-1.5 hours, the manifestations of withdrawal syndrome completely disappear or are significantly weakened. Positive results were obtained during acupuncture.

Regardless of the methods of stopping binge drinking and withdrawal symptoms, normalization of the condition is achieved within 3-7 days; in the presence of severe encephalopathy and severe somatic pathology, the process of normalization of the condition is delayed up to 2 weeks. Excessive administration of fluids, sedatives, and tranquilizers delays the normalization of the condition. Various complications (collapses, neuroleptic syndrome) can be caused by the use of aminazine, tizercin, especially in the presence of comorbid organic pathology.

In recent years, Naltrexone has been used as a drug to treat not only patients with opium addiction, but also alcoholism. The theoretical basis for the use of naltrexone is its ability to block opiate receptors. It is believed that the euphoric effect of alcohol will not occur if opiate receptors can be blocked.

You can start taking naltrexone in the form of antaxone even during a binge. There is a category of patients who refuse any anti-alcohol treatment under the pretext of the severity of the condition that occurs when they stop drinking alcohol. Regular intake of antaxone often leads to a sharp reduction in the daily dose of alcohol consumed and an improvement in the course of withdrawal symptoms. Then patients stop drinking alcohol. The intensity of the desire for intoxication decreases sharply. In cases where therapy by any other means is ineffective, taking antaxone can be very useful.

Antaxon can also be prescribed to prevent relapse of the disease. In this case, naturally, the intensity and duration of existence of the pathological attraction to intoxication are taken into account. The drug can be prescribed immediately after stopping the binge, when there is a pathological desire for intoxication or there is reason to expect its appearance in the next 10-12 days. In cases where the craving for alcohol is updated regularly 3 months after stopping alcohol intake, antaxone is prescribed in advance 7-10 days before the expected appearance of the pathological craving. The duration of taking the drug is determined by the clinical characteristics of the disease, primarily by the characteristics of the pathological craving for alcohol.

It is important to remember that as soon as the drug is stopped, the euphoric effect of alcohol resumes again. Therefore, taking antaxone should be quite long. Most often, the drug is prescribed parenterally at 50 mg (1 tablet) per day. When taking this dosage of antaxone, side effects are very rare.

Antakson can also be recommended for relieving binge drinking and withdrawal intoxication in women and elderly patients.

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Treatment

Treatment of withdrawal symptoms should be carried out in any case, regardless of the severity of the symptoms. Since ethyl alcohol has become so important for the patient’s body that it cannot fully function without it, in the advanced stage the strength is so depleted that this can lead to serious complications or death of the patient. In addition, treatment must be carried out due to the person’s inadequate condition, in which he can cause harm to others or himself.

Post-alcohol syndrome is a reversible condition that can go away on its own without medical help, but the risk is so great that it is not worth leaving abstinence without treatment. Treatment for a hangover can be done at home, but in cases of severe alcohol withdrawal it is better to treat it in a hospital setting in a drug treatment clinic.

Important: the home method of treatment can be used only if the patient does not have chronic diseases, has no more than 5 years of alcoholism, no more than 7 days of heavy drinking, and also provided that the patient’s age does not exceed 60 years.

Drug treatment

In case of alcohol withdrawal, complex measures are used for treatment, which are aimed at detoxifying the body, that is, cleansing it of ethyl alcohol, and restoring the functioning of the main systems.

The set of medications and their dosage for the treatment of withdrawal may vary, depending on the severity of the disease and the patient’s condition, therefore it is selected by the doctor individually. Typically, the following groups of drugs are used in treatment:

1. Vitamin therapy is mandatory. This helps restore the normal functioning of the nervous system and other important organs, as well as protect them from the negative effects of ethyl alcohol:
2. Thiamine improves the passage of nerve intercellular impulses. As a result, the functions of the nervous system improve, and tremor disappears.
3. Pyridoxine hydrochloride is used to improve the functioning of the spinal cord, brain, and peripheral nervous system. Thanks to the improvement of metabolic processes, acetaldehyde, a product of the processing of ethyl alcohol, is eliminated from the body faster.
4. Nicotinic acid has a vasodilating effect and normalizes metabolism in the body. This improves the supply of oxygen to all tissues and organs.
5. Ascorbic acid has an antioxidant effect. It protects cells from the negative effects of free radicals, since their level in a person with alcoholism is very elevated.

1. Drug treatment also includes detoxification therapy. Usually, special drugs are used for these purposes, which are administered intravenously. They allow you to quickly get rid of ethyl alcohol:
2. Unithiol is a product that can bind toxins, neutralize their effects and remove them from the body.
3. Sodium thiosulfate - this drug also neutralizes the effect of toxic substances, binds and removes them from the patient’s body.
4. A glucose solution gives the body energy and helps it quickly cope with intoxication resulting from drinking alcohol.
5. Urea. To relieve cerebral edema, a urea solution is prescribed. It helps restore water balance in the body.
6. Magnesia has a complex effect on the body. Magnesium ions calm and normalize the psycho-emotional state of the patient. The drug has a vasodilating effect and helps saturate the body with oxygen. Magnesia has a diuretic effect, accelerates the removal of toxic substances from the blood, and lowers blood pressure. In addition, the drug has an anticonvulsant effect and reduces swelling of the brain.
7. A 0.9 percent sodium chloride solution helps restore water and electrolyte balance, fights dehydration and serves as the basis for drip administration of other medications.
8. Hemodesis allows you to replenish the lack of fluid, binds and removes toxins, and also reduces blood clotting.

1. Psychotropic drugs are used to eliminate mental disorders. They help remove excessive aggressiveness, anxiety, delusions, irritability and hallucinations. It is especially important to use them during delirium tremens. Among the psychotropic drugs it is worth noting the following:
2. Diazepam is an anticonvulsant, sedative that relieves muscle tone and has a mild hypnotic effect.
3. Phenazepam is very similar to diazepam. It has a stronger calming effect and relieves anxiety well.
4. Grandaxin is a mild substance for eliminating anxiety. Unlike the two drugs listed above, it does not reduce muscle tone and does not have a pronounced hypnotic effect.
5. Haloperidol helps eliminate mental disorders, eliminates hallucinations and delusions, and has a sedative and antiemetic effect.

1. Additional drugs:
2. Glycine is an amino acid that helps neutralize and accelerate the elimination of acetaldehyde from the patient’s body. Thanks to taking this drug, inhibitory protective impulses passing through the brain are enhanced.
3. Piracetam is a nootropic drug that helps improve brain function. It improves concentration, memory, and thinking abilities.

1. A necessary condition for complex treatment of withdrawal syndrome is symptomatic therapy. Depending on the patient’s condition and the presence of certain symptoms, anticonvulsants, drugs to lower blood pressure, hepatoprotectors to protect the liver, compounds to reduce the acidity of gastric juice, and a drug (nitroglycerin) to treat heart disease are prescribed.

Suppressing the desire for intoxication and eliminating affective disorders

After the withdrawal syndrome has been relieved, it is necessary to suppress the remaining desire for intoxication, if it is sufficiently pronounced, and eliminate affective disorders. Suppression of the desire for intoxication is achieved mainly with the help of antipsychotics.

The most commonly used drugs are:

• haloperidol - up to 10 mg per day,
• neuleptil - up to 20 mg per day,
• Melleril (Sonapax) 50-100 mg 2-3 times a day,
• chlorp-rothixene - 15 mg 2-3 times a day,
• phosphobenzide 1.5 mg per day,
• carbidine - 25 mg 3 times a day,
• Mebicar 0.3 mg 3 times a day.

The choice of these drugs is made taking into account mental status.

In the first 3 days, to eliminate low mood, pyrazidol 50 mg 3 times a day, lerivon 30-60 mg at night, tianeptine (Coaxil) 37.5 mg per day, remeron 15-30 mg per day are prescribed. In the future, you can use tricyclic antidepressants - melipramine, amitriptyline, anafranil, as well as ludiomil in medium therapeutic doses.

Starting from the 4th day of abstinence from alcohol, for insomnia, azaleptin 50 mg is prescribed at night. Anxiety can be eliminated with phenazepam (0.0005-0.001 2-3 times a day), alprozalam (0.25-0.5 mg 3 times a day), lorazepam (1.25-5 mg 2-3 times a day). day). Phenazepam and seduxen should be prescribed in short courses, because Patients with alcoholism become accustomed to them quite quickly.

In case of severe anxiety, antipsychotics can be used: sulpiride (eglonil) in a daily dose of up to 800 mg, tiapride (ti-apridal) - 200-300 mg per day in tablets.

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Clinical picture - how does withdrawal manifest itself?

Withdrawal syndrome is represented by a group of psychopathological, somatic, autonomic and neurological symptoms. It is better to consider clinical manifestations according to the stages of development of addiction:

• Stage I. Abstinence is typical from the period of the first stage to the second. The condition occurs during short-term binges of no more than 3 days and is characterized by profuse sweating with a foul odor, dry mouth, and tachycardia.
• Stage II. It is registered at the peak of addiction formation, when binge drinking continues for at least 5-10 days. Autonomic disorders are complemented by neurological disorders and organ dysfunction. A hangover with withdrawal is complicated by nervous excitement, blood pressure lability, heaviness in the head, tremors of the limbs, and redness of the skin.
• Stage III. Binges become prolonged, reaching 14 days or more. Mental disorders with sleep disturbances, melancholy and apathy, aggressive behavior even towards the most beloved people, increased anxiety, feelings of guilt and self-deprecation, and nightmares come to the fore.

The predominance of certain symptoms depends on the age, gender of the patient, the number and strength of drinks consumed. A distinctive feature of withdrawal and hangover is an increase in cravings for drinking, mainly in the evening hours. Early symptoms appear after 12-48 hours. Subsequently, the signs soften and completely disappear after a few days. The most difficult period in giving up alcohol in patients with abstinence is the first week after withdrawal. It is during this period that alcoholics most often break down, making promises to loved ones to “quit” on their own. Irritation, nervous excitability, increased heart rate depress the quality of life. Thoughts about alcohol become obsessive, and ideas about drinking cause satisfaction.

Professional help from a narcologist consists of medicinal cleansing of the body in order to prevent early failure to quit alcohol associated with an increase in withdrawal syndrome. When all early and late signs appear, the risk of alcoholic delirium, popularly known as an attack of delirium tremens, an epileptic seizure, increases.

Anti-alcohol therapy

After normalization of sleep and mood is achieved, appetite is restored, asthenic manifestations disappear, anti-alcohol therapy in the narrow sense of the word begins. The system of psychotherapeutic measures is of primary importance.

Drug therapy plays a subordinate role. To maintain remission, aversive therapy , the purpose of which is to suppress the desire for alcohol and develop an aversion to it.

For this, a 1% solution of apomorphine is used, which is administered in a dose that induces vomiting (from 0.1 to 0.5). Each session involves giving a small amount of alcohol, after which vomiting occurs. Such sessions are carried out 10-15, until a persistent aversion to alcohol develops or an indifferent attitude towards it appears. According to Burenkov's method, 1.7-1.8 1% apomorphine solution is immediately administered and emetic mixtures are given; If vomiting occurs, small doses of alcohol are offered.

Therapy with apomorphine and other emetics (emetine, heavy metal salts) is effective only with simultaneous psychotherapy (explaining the goals and objectives of treatment, indicating the rapidity of onset of aversion to alcohol, references to long-term remissions, etc.). Apomorphine therapy sessions can be repeated periodically if, after a while, a desire for intoxication arises.

To relieve the pathological desire for intoxication that occurs during remission, short-term courses of pyrotherapy can be used. For the same purposes, they sometimes resort to prescribing antipsychotics with a prolonged action: moditene depot 12.5-25 mg for 2 weeks, haloperidol decanoate - 50-150 mg (1-3 ml) per injection, piportil - 100 mg per injection. At the same time, cyclodol is prescribed to prevent the occurrence of a side effect (neurolepsy).

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Sensitizing therapy

One type of maintenance treatment is sensitizing therapy. The most common and most effective remedy is tetraethylthiuram disulfide (tetu-ram, antabuse, disulfiram). Drinking alcohol while taking Teturam leads to an alcohol-Teturam reaction. A painful condition occurs with redness of the skin, a decrease in blood pressure, especially diastolic. Tachycardia, shortness of breath, and weakness appear. In the most severe cases, cyanosis of the lips occurs, hyperemia is replaced by pallor of the skin, and collaptoid states occur. Teturam can be prescribed

for a long time (several months), at a dose of 0.25-0.3 per day. If the patient violates the sobriety regime and an alcohol-teturam reaction occurs, the dose of teturam is increased to 0.5 per day for several days to prevent binge drinking. Carrying out therapeutic alcohol-teturam reactions is not at all necessary, although in many cases even one alcohol-teturam reaction sharply reduces or eliminates the desire for intoxication.

Less effective is calcium urea citrate (tempozil), the effect of which is similar to that of teturam. The drug is absorbed faster, but is also eliminated from the body faster. 0.1 tempozil is given per day.

Other drugs used for sensitizing therapy include furazolidone, furadonin and metronidazole. The use of these drugs is less effective than teturama.

When conducting sensitizing therapy, psychotherapeutic effects are of great importance. The goals and objectives of treatment must be explained to the patient. The period of forced abstinence from alcohol is used for active psychotherapeutic influence. In many cases, the effectiveness of sensitizing therapy is not associated with the fear of death if the sobriety regime is violated, but with a decrease or disappearance of the desire for intoxication and a change in the patient’s position regarding a sober lifestyle.

To maintain remission, acamprosate was used, which is prescribed for a long period (up to 1 year) up to 2 g per day.

Long-term treatment with naltrexone (50 mg per day) can also be carried out; the course of treatment takes many months if the drug is well tolerated.

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Possible complications and consequences

If treatment is severe, then abstinence therapy should be carried out strictly in a drug treatment clinic.

Withdrawal symptoms definitely require treatment. Even at home, the body needs to be helped to cope with the consequences of long-term drinking. Nerve cells are particularly affected during withdrawal. Alcoholics develop a variety of disorders, manifested by attacks of irritability and memory impairment, up to partial memory loss.

Cardiovascular structures also suffer no less from withdrawal, which increases the risk of developing such dangerous consequences as arrhythmia attacks, strokes or heart attacks. The liver also suffers in similar conditions, which manifests itself in hepatitis and cirrhosis. And while alcoholic hepatitis can somehow be cured, cirrhosis cannot be eliminated by any means.

Also, various psychoses of alcohol origin can occur as complications of withdrawal:

• delirium tremens;
• the occurrence of hallucinosis, which is characterized by the appearance of visual or auditory hallucinations;
• encephalopathy accompanied by serious impairment of motor or speech functions;
• delusional psychoses such as delusions of jealousy or persecution mania, etc.;
• alcoholic dementia;
• amnestic disorders;
• epilepsy attacks.

In addition, with frequent long-term binges, existing pathologies such as gastric or duodenal ulcers, renal failure or diabetes are aggravated. The earlier treatment is started, the lower the risk of developing undesirable consequences. If you decide to treat withdrawal symptoms at home, it is recommended that you consult with a narcologist about your medication options.

With a mild degree of alcohol withdrawal syndrome, all pathological signs disappear in the first few days, usually no more than 5 days. Severe cases of abstinence require mandatory medical attention and hospitalization of the alcoholic in a narcological department.

We invite you to familiarize yourself with Drugs for treating alcoholism at home

Alcohol syndrome represents severe stress for all organs. The emergency mode of operation of the nervous, endocrine, genitourinary, and digestive systems is activated. The organs simply cannot stand it, self-defense mechanisms break down. Consequences of alcohol withdrawal:

• Mallory-Weiss syndrome, leading to gastric bleeding;
• stroke due to excessive increase in blood pressure;
• hemorrhoids due to intestinal dysfunction;
• severe heart rhythm disturbances - ventricular fibrillation, which can be fatal;
• suicide attempts due to frightening hallucinations;
• convulsions can cause death due to respiratory arrest.

The problem of alcohol syndrome is not only medical, but also social. The personality of an alcoholic deteriorates. Family relationships are destroyed. An addicted person loses his job. His friends turn away from him, but the same drunken drinking buddies appear.